title: Virtual mediastinoscopy for safer and more accurate mediastinal exploration.
abstract: OBJECTIVE
  Virtual endoscopy can theoretically produce images of hollow organs from computed tomographic scanning by discriminating walls with the air space. We produced virtual images of the mediastinum (ie, virtual mediastinoscopy based on positron emission tomography and computed tomography scanning data to visualize lymph nodes and great vessels similar to cervical mediastinoscopy).
  
  
  METHODS
  Virtual images from 5 patients with positive mediastinal positron emission tomography findings were produced using computer software designed for virtual endoscopy. Visualization of lymph nodes and vessels was done based on positron emission tomography-computed tomography and enhanced computed tomographic scanning data, respectively.
  
  
  RESULTS
  Virtual mediastinoscopy clearly showed three-dimensional relationships between active nodes and surrounding structures. Great vessels, such as the innominate artery and azygos vein, which require assessment during a mediastinoscopy, were visualized in virtual movies. Further, perspective views in the craniocaudal direction based on surgeon-orientation, simulated actual views were obtained during cervical video mediastinoscopy.
  
  
  CONCLUSIONS
  Virtual mediastinoscopy provided realistic images of the mediastinal anatomy, and has the potential to make cervical mediastinoscopy and other mediastinal explorations safer, as well as more accurate.
authors.affiliation: Medical Center for Translational Research, Osaka University Hospital, Osaka, Japan. hishiro@surg1.med.osaka-u.ac.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shiono
authors.forename: Meinoshin
authors.initials: M
authors.lastname: Okumura
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Sawabata
authors.forename: Tomoki
authors.initials: T
authors.lastname: Utsumi
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Inoue
authors.forename: Masato
authors.initials: M
authors.lastname: Minami
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Tomiyama
authors.forename: Hikaru
authors.initials: H
authors.lastname: Matsuda
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sawa
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008481:Mediastinoscopy / Q000379:methods*; D008482:Mediastinum / Q000473:pathology*; D008875:Middle Aged; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed