VIRTUAL BRONCHOSCOPY - RELATIONSHIPS OF VIRTUAL-REALITY ENDOBRONCHIALSIMULATIONS TO ACTUAL BRONCHOSCOPIC FINDINGS

Advances in computer technology have permitted development of virtual reality images of the tracheobronchial tree using data sets derived fr om helical CT of the chest. To determine the relevance of these images to actual bronchoscopic findings, we compared ''virtual bronchoscopy' ' images with videotaped bronchoscopy results in 20 patients who had u ndergone both helical chest CT and fiberoptic bronchoscopy during clin ical evaluation of their thoracic problems. Suboptimal endobronchial s imulations in ten patients identified important, readily-addressed tec hnical requirements for this imaging procedure. In the ten patients wi th technically suitable renderings of the airway, virtual bronchoscopy simulations accurately demonstrated endobronchial obstructions by tum or in five, airway distortion and/or ectasia in four, and accessory br onchi in another. These preliminary observations suggest that virtual bronchoscopy simulations accurately represent major endobronchial anat omic findings. This technique may have a role in prebronchoscopy plann ing, endoscopy training, and/or endobronchial therapy, and merits furt her study.