Comparison of the Results Obtained with Spiral Computerized Tomography and Fiberoptic Bronchoscopy of the Airways of Lung Cancer Patients

Background: Although fiberoptic bronchoscopy is a safe and effective method in diagnosis of lung carcinoma, spiral computed tomography is capable of imaging the lungs and other intrathoracic structures with excellent anatomic detail.

Objective: The present study was aimed at determining the role of fiberoptic bronchoscopy and spiral computed tomogra­phy in localization of endobronchial lesions.

Methods: Fiberoptic bronchoscopy was performed in 45 patients with suspected lung cancer. Lesions were classified as endobronchial, submucosal and peribronchial. Spiral com­puted tomography scan was performed in all patients after bronchoscopic examination. Two radiologists, independent to each other, reported computed tomography scans.

Results: Fiberoptic bronchoscopy and computed tomography were in concordance with each other in the demonstration of bronchial involvement, but at the fourth order or distal bronchi there was some discordance between the results of two proce­dures. The lesions in 11 of 13 cases whose bronchoscopic exam­inations demonstrated stenosis, were also reported as stenosis on computed tomography, so sensitivity of computed tomogra­phy was 85%. For submucosal lesions it was 80%, for endo­bronchial lesions it was 56%. There was some variability between the readers’ reports.

Conclusion: Although spiral computed tomography can not replace fiberoptic bronchoscopy, it is a supplementary diagnos­tic method and serves as a guide for fiberoptic bronchoscopy.