Diagnostic Validity of Computed Tomography Thorax in Comparison with Fibreoptic Bronchoscopy for Endobronchial Lesions

Abstract

Introduction: Fibreoptic Bronchoscopy (FOB) is the gold standard for diagnosis of endobronchial diseases, an invasive procedure not without risks. Computed Tomography (CT) illustration of thoracic anatomy provides guidance in sampling procedure for diagnosis of endobronchial disease through FOB. Yet, in real life scenario, we find discrepancy between findings of CT and bronchoscopy which necessitates the patients to undergo second invasive procedure for a definitive diagnosis. Aim: To assess the diagnostic validity of CT imaging in diagnosing endobronchial diseases by comparing with FOB findings and to correlate FOB findings with pathological results. Materials and Methods: This was a cross-sectional retrospective analysis over six years in a tertiary care centre from January 2012 to December 2018. The findings on CT and FOB were classified as normal, abnormal mucosa, mass and extrinsic compression. FOB samples were sent for pathological examination. Results: A total of 426 patients were included in the study. The sensitivity of CT for presence of normal bronchus, abnormal mucosa, mass and extrinsic compression was 93.03%, 27.50%, 89.00% and 59.52% and specificity was 91.76%, 98.45%, 89.88% and 94.79%, respectively. Pathological diagnosis was obtained in 135(97.12%) out of 139 cases. Squamous cell carcinoma was the most common 62 (41.01%) histological diagnosis. Conclusion: Computed Tomography (CT) thorax imaging has good sensitivity and specificity to detect endobronchial mass but has poor sensitivity for detection of extrinsic compression and mucosal abnormalities in bronchi. Squamous cell carcinoma was the most common pathological diagnosis.