CT Virtual Bronchoscopy, Multi-Detector CT Chest versus Fiberoptic Bronchoscopy in detecting Lung Collapse

Background: Fiber-optic bronchoscopy (FOB) is the gold standard for diagnosing tracheobronchial lesions, but has limitations including invasiveness and restricted access to certain airways. Virtual bronchoscopy (VB), utilizing multidetector CT scans (MDCT), offers a noninvasive alternative for airway assessment. Objective: This study aimed to evaluate the diagnostic accuracy of CT-based virtual bronchoscopy, MDCT Chest, compared to Fiber-optic bronchoscopy in detecting lung collapse. Methods: This cross-sectional hospital-based diagnostic study was conducted on 40 patients at the Cardiothoracic Hospital, Minia University, Egypt, all of whom had clinical and radiological indications for bronchoscopy. All patients underwent chest X-ray, CT with virtual bronchoscopy, and FOB. Findings from each modality were compared. Results: Both chest X-ray and CT identified lung collapse in 24 cases (60%), with perfect agreement (κ = 1.0, p < 0.001). Virtual bronchoscopy demonstrated great concordance with fiber-optic bronchoscopy findings in all cases of lung collapse, achieving 85% sensitivity, specificity, and diagnostic accuracy (AUC = 0.85). In comparison, MDCT chest findings showed moderate agreement with FOB (κ = 0.40, p = 0.01), with 80% sensitivity and 60% specificity for detecting collapse. Conclusion: Virtual bronchoscopy demonstrated diagnostic performance as accurate as fiber-optic bronchoscopy in identifying lung collapse, offering a highly accurate, noninvasive, and patient-friendly alternative. This technique may enhance preoperative planning and patient management, especially in cases where FOB is contraindicated or not tolerated.