CT-based virtual tracheobronchoscopy in children--comparison with axial CT and multiplanar reconstruction: preliminary results

Pediatr Radiol. 2002 Jan;32(1):8-15. doi: 10.1007/s00247-001-0574-6. Epub 2001 Nov 6.


Background: 3D post-processing of spiral-CT (S-CT) data using perspective projection allows the generation of virtual views similar to endoscopy.

Objective: To evaluate whether simultaneous reading of axial S-CT, multiplanar reconstruction (MPR) and virtual tracheobronchoscopy (VTB) is more precise and accurate than reading of axial S-CT and MPR alone in paediatric patients.

Materials and methods: S-CT studies of 15 symptomatic and 4 normal patients were investigated. Two radiologists independently read two sets of images for airway abnormalities: first axial CT and MPR, followed by axial CT, MPR and VTB. A final decision was later made by consensus. All results were compared to fibre-optic bronchoscopy (FTB). Interobserver agreement was used as an indicator of precision for the display technique used.

Results: At reading of axial S-CT and MPR an interobserver agreement of 89.5% (kappa=0.776, P<0.00103) was found. Based on the consensus decision, a diagnostic accuracy of 89.5% at a sensitivity 86.6% and specificity of 100% (kappa=0.776, 95% CI 0.491-1.062, P<0.00103) was achieved. At reporting on axial S-CT, MPR and VTB, all cases were classified correctly by both readers, indicating 100% accuracy, interobserver agreement, sensitivity and specificity (kappa=1.00, 95% CI 1.0-1.0, P<0.000258).

Conclusions: The simultaneous display of axial S-CT, MPR and VTB raises the precision, accuracy and sensitivity of radiological reports.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Bronchoscopy
  • Child
  • Child, Preschool
  • Endoscopy
  • Fiber Optic Technology
  • Humans
  • Image Processing, Computer-Assisted*
  • Imaging, Three-Dimensional
  • Infant
  • Prospective Studies
  • Tomography, X-Ray Computed*
  • Tracheal Diseases / diagnostic imaging*