Head and neck computed tomography virtual endoscopy: evaluation of a new imaging technique.
OBJECTIVE
To evaluate a new radiographic imaging technique: computed tomography virtual endoscopy (CTVE) for head and neck tumors.


METHODS
Twenty-one patients presenting with head and neck masses who underwent axial computed tomography (CT) scan with contrast were evaluated by CTVE. Comparisons were made with video-recorded images and operative records to evaluate the potential utility of this new imaging technique.


METHODS
Twenty-one patients with aerodigestive head and neck tumors were evaluated by CTVE. One patient had a nasal cylindrical cell papilloma; the remainder, squamous cell carcinomas distributed throughout the upper aerodigestive tract. Patients underwent complete head and neck examination, flexible laryngoscopy, axial CT with contrast, CTVE, and in most cases, operative endoscopy. Available clinical and radiographic evaluations were compared and correlated to CTVE findings.


RESULTS
CTVE accurately demonstrated abnormalities caused by intraluminal tumor, but where there was apposition of normal tissue against tumor, inaccurate depictions of surface contour occurred. Contour resolution was limited, and mucosal irregularity could not be defined. There was very good overall correlation between virtual images, flexible laryngoscopic findings, rigid endoscopy, and operative evaluation in cases where oncological resections were performed. CTVE appears to be most accurate in evaluation of subglottic and nasopharyngeal anatomy in our series of patients.


CONCLUSIONS
CTVE is a new radiographic technique that provides surface-contour details. The technique is undergoing rapid technical evolution, and although the image quality is limited in situations where there is apposition of tissue folds, there are a number of potential applications for this new imaging technique.
Gallivan
R P
RP
Department of Otolaryngology-Head & Neck Surgery, University of California, Irvine, USA.
Nguyen
T H
TH
Armstrong
W B
WB
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging*; D004724:Endoscopy / Q000379:methods*; D005069:Evaluation Studies as Topic; D005931:Glottis; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000000981:diagnostic imaging; D007091:Image Processing, Computer-Assisted; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging; D009959:Oropharyngeal Neoplasms / Q000000981:diagnostic imaging; D010865:Pilot Projects; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014134:Tracheal Neoplasms / Q000000981:diagnostic imaging; D020535:Video-Assisted Surgery