Accuracy of virtual bronchoscopy for grading tracheobronchial stenosis: Correlation with pulmonary function test and fiberoptic bronchoscopy

Study objectives: To compare the accuracy of virtual bronchoscopy (VB) with fiberoptic bronchoscopy (FOB) and pulmonary function testing (PFT) for the assessment of tracheal stenosis and bronchial anastomotic stenosis. Design: Prospective case series. Setting: Pulmonary institute of major tertiary university-affiliated center. Patients: The study group included 10 lung transplant recipients and 13 patients with central airway stenosis. Interventions: All patients underwent PFT, VB, and FOB. All cases were graded by each modality on a scale of 1 to 3, and the findings were compared between modalities. Results: Mean ± SD stenosis score was 2.0 ± 0.79 for PFT, 1.62 ± 0.73 for FOB, and 1.82 ± 0.77 for VB. A statistically significant correlation was found between VB and FOB scores (p < 0.0001, r = 0.76) and between VB scores and PFT (p = 0.03, r = 0.45). There was no correlation between PFT and FOB. Conclusions: VB grading of tracheobronchial stenosis is well correlated with PFT. VB may be used to evaluate patients with known tracheobronchial stenosis after treatment and thereby reduce the frequency of repeated invasive FOB performed for that purpose. The correlation of VB with PFT may improve the reliability of this approach.