title: CT-based virtual tracheobronchoscopy in children--comparison with axial CT and multiplanar reconstruction: preliminary results.
abstract: 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.
  
  
  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.
authors.affiliation: Division of Paediatric Radiology, Department of Radiology, University Hospital Graz, Auenbruggerplatz 34, 8036 Graz, Austria. erich.sorantin@kfunigraz.ac.at
authors.forename: Erich
authors.initials: E
authors.lastname: Sorantin
authors.forename: Bernhard
authors.initials: B
authors.lastname: Geiger
authors.forename: Franz
authors.initials: F
authors.lastname: Lindbichler
authors.forename: Ernst
authors.initials: E
authors.lastname: Eber
authors.forename: Guenther
authors.initials: G
authors.lastname: Schimpl
mesh_terms: D000293:Adolescent; D000328:Adult; D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy; D005336:Fiber Optic Technology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007223:Infant; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D014133:Tracheal Diseases / Q000000981:diagnostic imaging*