Virtual bronchoscopy is a non-invasive procedure that creates a 3D rendering of a patient’s airway and surrounding structures using CT scans. It can detect lesions, tumors, narrow passages, and foreign bodies, and guide instruments for treatment or biopsy. It is useful for young children, elderly patients, and those who cannot tolerate invasive procedures. It can also detect masses or lesions from inflammation or cancer, and accurately display the outline, size, and structure of foreign bodies for removal. More complex uses, such as guiding lymph node biopsies, are still in clinical trials.
Virtual bronchoscopy is a process by which a medical professional can obtain information about a patient’s airway and surrounding structures before using a bronchoscope on a patient. Using multiple overlays of views from computed tomography (CT) scans, a three-dimensional (3D) rendering of the bronchial airways and lungs can show any lesions, tumors, abnormally narrow passages, or any foreign bodies that may have been aspirated. A bronchoscopist, assisted by these 3D images, can guide instruments directly to the source of respiratory problems to apply treatments or biopsy tissue. Additionally, whether a balloon is needed to expand a pathway or a stent needs to be placed, precise diameter and length measurements can be found out before the procedure.
The virtual bronchoscopy procedure is non-invasive and, for this reason, is often used for young children, elderly patients, and those whose health conditions are unstable or cannot tolerate invasive procedures. By virtually examining the views, doctors can detect masses or lesions from inflammation or cancer. The software used for virtual bronchoscopy allows a doctor to virtually “travel” through the airways and determine if any pockets or tumors are blocking the blood vessels or aorta. It’s also possible to see if lymph nodes outside the bronchi or within the hilar regions of the lung, in the center, near the heart, might be affected.
Simple bronchoscopy procedures, guided by prior virtual bronchoscopy, have been used since the 1990s in very young children. Because plain chest X-rays often detect no more than 30% of foreign bodies, virtual bronchoscopy can often show exactly where a foreign body is. The outline, size and structure of a foreign body can be accurately displayed; this allows for careful planning of the removal, which can reduce the time required for sedation and treatment. For example, a plain x-ray may not detect an aspirated grain of rice, but a virtual bronchoscopy can accurately detect it.
More complex uses of virtual bronchoscopy, such as guiding bronchoscopists during lymph node biopsies, are still in clinical trials. These nodes can be located just outside the bronchial passages or in the hilar regions of the upper lungs. During a normal bronchoscopy, lymph nodes outside the bronchial passages cannot be visualized or accurately located. However, using virtual bronchoscopy images overlaid on real bronchoscopy images in real time allows the physician to visualize the entire outline of a lymph node for an accurate needle biopsy through the walls of a bronchial passage.
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