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Ann Thorac Surg 2005;79:365-374
© 2005 The Society of Thoracic Surgeons

Review

Is Virtual Bronchoscopy an Efficient Diagnostic Tool for the Thoracic Surgeon?

Catherine M. Jones, MBBSa, Thanos Athanasiou, MD, PhDa,*

a The National Heart and Lung Institute Imperial College of Science, Technology and Medicine, Department of Cardiothoracic Surgery, St. Mary's Hospital, London, United Kingdom

* Address reprint requests to Dr Anthanasiou, Robotic and Minimally Invasive Cardiothoracic Surgery, 70 St Olaf's Rd, Fulham, London SW6 7DN, UK
tathan5253{at}aol.com

Virtual bronchoscopy has emerged over the past decade as a potentially complementary investigation to conventional bronchoscopy in the diagnosis, grading, and monitoring of pulmonary disease. A meta-analysis reporting on the use of virtual bronchoscopy has not yet been performed. The primary aim of this study is to evaluate its diagnostic accuracy compared to the gold standard investigation of conventional bronchoscopy (fiberoptic or rigid). Quantitative data synthesis included the calculation of independent sensitivity and specificity, construction of summary receiver operating characteristic curves, pooled analysis, and sensitivity analysis. Seventeen studies were identified comprising 459 patients. The calculated pooled sensitivity was 84% (95% CI, 78% to 89%), specificity 75% (95% CI, 62% to 85%) and area under the curve was 0.92, which shows good diagnostic performance. Meta-analysis confirms virtual bronchoscopy is very discriminating in the evaluation of patients with significant airway stenosis that is due to a wide spectrum of pathologic conditions. It can potentially have a beneficial role in selected thoracic patients (with bronchoesophageal fistulas, postlung transplantation, anastomoses, and suspected foreign body aspiration).


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