Karen S Lee1, Maryellen R M Sun1, Armin Ernst2, David Feller-Kopman1, Adnan Majid1, Phillip M Boiselle1. 1. Center for Airway Imaging, Department of Radiology, and Division of Thoracic Surgery and Interventional Pulmonary, Beth Israel Deaconess Medical Center, Boston, MA. 2. Center for Airway Imaging, Department of Radiology, and Division of Thoracic Surgery and Interventional Pulmonary, Beth Israel Deaconess Medical Center, Boston, MA. Electronic address: aernst@bidmc.harvard.edu.
Abstract
OBJECTIVE: To assess the accuracy of dynamic expiratory CT for detecting airway malacia using bronchoscopy as the diagnostic "gold standard." MATERIALS AND METHODS: A computerized hospital information system was used to retrospectively identify all patients with bronchoscopically proven airway malacia referred for CT airway imaging at our institution during a 19-month period. CT was performed within 1 week of bronchoscopy. All patients were scanned with a standard protocol, including end-inspiratory and dynamic expiratory volumetric imaging, using an eight-detector multislice helical CT scanner. For both CT and bronchoscopy, malacia was defined as >/= 50% expiratory reduction of the airway lumen. CT and bronchoscopic findings were subsequently jointly reviewed by the radiologist and bronchoscopist for concordance. RESULTS: Twenty-nine patients (12 men and 17 women; mean age, 60 years; range, 36 to 79 years) comprised the study cohort. CT correctly diagnosed malacia in 28 of 29 patients (97%). The most common presenting symptoms were dyspnea in 20 patients (69%), severe or persistent cough in 16 patients (55%), and recurrent infection in 7 patients (24%). The estimated radiation dose (expressed as dose-length product) for the dual-phase study is 508 mGy-cm, which is comparable to a routine chest CT. CONCLUSION: Dynamic expiratory CT is a highly sensitive method for detecting airway malacia and has the potential to serve as an effective, noninvasive test for diagnosing this condition.
OBJECTIVE: To assess the accuracy of dynamic expiratory CT for detecting airway malacia using bronchoscopy as the diagnostic "gold standard." MATERIALS AND METHODS: A computerized hospital information system was used to retrospectively identify all patients with bronchoscopically proven airway malacia referred for CT airway imaging at our institution during a 19-month period. CT was performed within 1 week of bronchoscopy. All patients were scanned with a standard protocol, including end-inspiratory and dynamic expiratory volumetric imaging, using an eight-detector multislice helical CT scanner. For both CT and bronchoscopy, malacia was defined as >/= 50% expiratory reduction of the airway lumen. CT and bronchoscopic findings were subsequently jointly reviewed by the radiologist and bronchoscopist for concordance. RESULTS: Twenty-nine patients (12 men and 17 women; mean age, 60 years; range, 36 to 79 years) comprised the study cohort. CT correctly diagnosed malacia in 28 of 29 patients (97%). The most common presenting symptoms were dyspnea in 20 patients (69%), severe or persistent cough in 16 patients (55%), and recurrent infection in 7 patients (24%). The estimated radiation dose (expressed as dose-length product) for the dual-phase study is 508 mGy-cm, which is comparable to a routine chest CT. CONCLUSION: Dynamic expiratory CT is a highly sensitive method for detecting airway malacia and has the potential to serve as an effective, noninvasive test for diagnosing this condition.
Authors: Phillip M Boiselle; Gaetane Michaud; David H Roberts; Stephen H Loring; Hilary M Womble; Mary E Millett; Carl R O'Donnell Journal: Chest Date: 2012-12 Impact factor: 9.410
Authors: Carles Sánchez; Jorge Bernal; F Javier Sánchez; Marta Diez; Antoni Rosell; Debora Gil Journal: Int J Comput Assist Radiol Surg Date: 2015-04-18 Impact factor: 2.924
Authors: Phillip M Boiselle; Carl R O'Donnell; Alexander A Bankier; Armin Ernst; Mary E Millet; Alexis Potemkin; Stephen H Loring Journal: Radiology Date: 2009-05-06 Impact factor: 11.105