Benign abnormalities and carcinoid tumors of the central airways: diagnostic impact of CT bronchography.
OBJECTIVE
The purpose of this retrospective study was to determine the added diagnostic value, if any, of CT bronchography for the detection and characterization of benign abnormalities and typical carcinoid tumors of the central airways.


METHODS
We used bronchoscopy and helical CT to examine 238 bronchial sections in 28 patients with 32 bronchial abnormalities and in five patients with normal bronchoscopy results. Postprocessing consisted of CT bronchography based on surface rendering. Images were interpreted independently by two observers (a radiologist and a pneumonologist) who were not informed of the bronchoscopy results. After initial interpretation of axial CT scans, the observers analyzed the axial CT scans with CT bronchograms. Results were evaluated for gain in diagnostic accuracy and in confidence.


RESULTS
Mean sensitivity for detection of abnormal bronchial sections was 89% (range, 87-90%) for axial CT and 92% (range, 90-94%) for axial CT with CT bronchography (not significant). Mean specificity of both approaches exceeded 99%. A correct diagnosis of the nature of the bronchial abnormalities was proposed for 68% of the cases in which axial CT was used alone and in 76% in which both axial CT and CT bronchography were used (not significant). The addition of CT bronchography significantly increased the confidence of the pneumonologist in the diagnoses.


CONCLUSIONS
Axial CT remains the technique of choice to detect and characterize benign abnormalities of the airways. CT bronchography provides little diagnostic gain but increases the confidence of chest physicians in the interpretation of CT scans for the assessment of benign abnormalities and typical carcinoids of the central airways.
Ferretti
G R
GR
Department of Radiology, Hôpital Michallon, Centre Hospitalier Universitaire, Grenoble, France.
Thony
F
F
Bosson
J L
JL
Pison
C
C
Arbib
F
F
Coulomb
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D001982:Bronchial Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging*; D001984:Bronchial Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging*; D001995:Bronchography; D001999:Bronchoscopy; D002276:Carcinoid Tumor / Q000175:diagnosis / Q000000981:diagnostic imaging*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014132:Trachea / Q000000981:diagnostic imaging; D014133:Tracheal Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging*