Comparison of virtual bronchoscopy to fiber-optic bronchoscopy for assessment of inhalation injury severity

Herbert P. Kwon; Thomas B. Zanders; Dara D. Regn; Samuel E. Burkett; John A. Ward; Ruth Nguyen; Corina Necsoiu; Bryan S. Jordan; Gerald E. York; Santiago Jimenez; Kevin K. Chung; Leopoldo C. Cancio; Michael J. Morris; Andriy I. Batchinsky

doi:10.1016/j.burns.2014.06.007

Comparison of virtual bronchoscopy to fiber-optic bronchoscopy for assessment of inhalation injury severity

Herbert P. Kwon, Thomas B. Zanders, Dara D. Regn, Samuel E. Burkett, John A. Ward, Ruth Nguyen, Corina Necsoiu, Bryan S. Jordan, Gerald E. York, Santiago Jimenez, Kevin K. Chung, Leopoldo C. Cancio, Michael J. Morris, Andriy I. Batchinsky^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

18 Scopus citations

Abstract

Purpose: Compare virtual bronchoscopy (VB) to fiberoptic bronchoscopy (FOB) for scoring smoke inhalation injury (SII).

Methods: Swine underwent computerized tomography (CT) with VB and FOB before (0) and 24 and 48 h after SII. VB and FOB images were scored by 5 providers off line.

Results: FOB and VB scores increased over time ( p < 0.001) with FOB scoring higher than VB at 0 (0.30 ± 0.79 vs. 0.03 ± 0.17), 24 h (4.21 ± 1.68 vs. 2.47 ± 1.50), and 48 h (4.55 ± 1.83 vs. 1.94 ± 1.29). FOB and VB showed association with PaO2-to-FiO2 ratios (PFR) with areas under receiver operating characteristic curves (ROC): for PFR ≤ 300, VB 0.830, FOB 0.863; for PFR ≤ 200, VB 0.794, FOB 0.825; for PFR ≤ 100, VB 0.747, FOB 0.777 (all p <; 0.001). FOB showed 80.3% specificity, 77% sensitivity, 88.8% negative-predictive value (NPV), and 62.3% positive-predictive value (PPV) for PFR ≤ 300 and VB showed 67.2% specificity, 85.5% sensitivity, 91.3% NPV, and 53.4% PPV.

Conclusions: VB provided similar injury severity scores to FOB, correlated with PFR, and reliably detected airway narrowing. VB performed during admission CT may be a useful screening tool specifically to demonstrate airway narrowing induced by SII.

Original language	English
Pages (from-to)	1308-1315
Number of pages	8
Journal	Burns
Volume	40
Issue number	7
DOIs	https://doi.org/10.1016/j.burns.2014.06.007
State	Published - 1 Nov 2014
Externally published	Yes

Keywords

Computed tomography scan
Fiber-optic bronchoscopy
Inhalation injury
Swine
Virtual bronchoscopy

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Kwon, H. P., Zanders, T. B., Regn, D. D., Burkett, S. E., Ward, J. A., Nguyen, R., Necsoiu, C., Jordan, B. S., York, G. E., Jimenez, S., Chung, K. K., Cancio, L. C., Morris, M. J., & Batchinsky, A. I. (2014). Comparison of virtual bronchoscopy to fiber-optic bronchoscopy for assessment of inhalation injury severity. Burns, 40(7), 1308-1315. https://doi.org/10.1016/j.burns.2014.06.007

@article{d551032cb4a2403fa51acf7e0ad14cda,

title = "Comparison of virtual bronchoscopy to fiber-optic bronchoscopy for assessment of inhalation injury severity",

abstract = "Purpose: Compare virtual bronchoscopy (VB) to fiberoptic bronchoscopy (FOB) for scoring smoke inhalation injury (SII).Methods: Swine underwent computerized tomography (CT) with VB and FOB before (0) and 24 and 48 h after SII. VB and FOB images were scored by 5 providers off line.Results: FOB and VB scores increased over time ( p < 0.001) with FOB scoring higher than VB at 0 (0.30 ± 0.79 vs. 0.03 ± 0.17), 24 h (4.21 ± 1.68 vs. 2.47 ± 1.50), and 48 h (4.55 ± 1.83 vs. 1.94 ± 1.29). FOB and VB showed association with PaO2-to-FiO2 ratios (PFR) with areas under receiver operating characteristic curves (ROC): for PFR ≤ 300, VB 0.830, FOB 0.863; for PFR ≤ 200, VB 0.794, FOB 0.825; for PFR ≤ 100, VB 0.747, FOB 0.777 (all p <; 0.001). FOB showed 80.3% specificity, 77% sensitivity, 88.8% negative-predictive value (NPV), and 62.3% positive-predictive value (PPV) for PFR ≤ 300 and VB showed 67.2% specificity, 85.5% sensitivity, 91.3% NPV, and 53.4% PPV.Conclusions: VB provided similar injury severity scores to FOB, correlated with PFR, and reliably detected airway narrowing. VB performed during admission CT may be a useful screening tool specifically to demonstrate airway narrowing induced by SII.",

keywords = "Computed tomography scan, Fiber-optic bronchoscopy, Inhalation injury, Swine, Virtual bronchoscopy",

author = "Kwon, {Herbert P.} and Zanders, {Thomas B.} and Regn, {Dara D.} and Burkett, {Samuel E.} and Ward, {John A.} and Ruth Nguyen and Corina Necsoiu and Jordan, {Bryan S.} and York, {Gerald E.} and Santiago Jimenez and Chung, {Kevin K.} and Cancio, {Leopoldo C.} and Morris, {Michael J.} and Batchinsky, {Andriy I.}",

year = "2014",

month = nov,

day = "1",

doi = "10.1016/j.burns.2014.06.007",

language = "English",

volume = "40",

pages = "1308--1315",

journal = "Burns",

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TY - JOUR

T1 - Comparison of virtual bronchoscopy to fiber-optic bronchoscopy for assessment of inhalation injury severity

AU - Kwon, Herbert P.

AU - Zanders, Thomas B.

AU - Regn, Dara D.

AU - Burkett, Samuel E.

AU - Ward, John A.

AU - Nguyen, Ruth

AU - Necsoiu, Corina

AU - Jordan, Bryan S.

AU - York, Gerald E.

AU - Jimenez, Santiago

AU - Chung, Kevin K.

AU - Cancio, Leopoldo C.

AU - Morris, Michael J.

AU - Batchinsky, Andriy I.

PY - 2014/11/1

Y1 - 2014/11/1

N2 - Purpose: Compare virtual bronchoscopy (VB) to fiberoptic bronchoscopy (FOB) for scoring smoke inhalation injury (SII).Methods: Swine underwent computerized tomography (CT) with VB and FOB before (0) and 24 and 48 h after SII. VB and FOB images were scored by 5 providers off line.Results: FOB and VB scores increased over time ( p < 0.001) with FOB scoring higher than VB at 0 (0.30 ± 0.79 vs. 0.03 ± 0.17), 24 h (4.21 ± 1.68 vs. 2.47 ± 1.50), and 48 h (4.55 ± 1.83 vs. 1.94 ± 1.29). FOB and VB showed association with PaO2-to-FiO2 ratios (PFR) with areas under receiver operating characteristic curves (ROC): for PFR ≤ 300, VB 0.830, FOB 0.863; for PFR ≤ 200, VB 0.794, FOB 0.825; for PFR ≤ 100, VB 0.747, FOB 0.777 (all p <; 0.001). FOB showed 80.3% specificity, 77% sensitivity, 88.8% negative-predictive value (NPV), and 62.3% positive-predictive value (PPV) for PFR ≤ 300 and VB showed 67.2% specificity, 85.5% sensitivity, 91.3% NPV, and 53.4% PPV.Conclusions: VB provided similar injury severity scores to FOB, correlated with PFR, and reliably detected airway narrowing. VB performed during admission CT may be a useful screening tool specifically to demonstrate airway narrowing induced by SII.

AB - Purpose: Compare virtual bronchoscopy (VB) to fiberoptic bronchoscopy (FOB) for scoring smoke inhalation injury (SII).Methods: Swine underwent computerized tomography (CT) with VB and FOB before (0) and 24 and 48 h after SII. VB and FOB images were scored by 5 providers off line.Results: FOB and VB scores increased over time ( p < 0.001) with FOB scoring higher than VB at 0 (0.30 ± 0.79 vs. 0.03 ± 0.17), 24 h (4.21 ± 1.68 vs. 2.47 ± 1.50), and 48 h (4.55 ± 1.83 vs. 1.94 ± 1.29). FOB and VB showed association with PaO2-to-FiO2 ratios (PFR) with areas under receiver operating characteristic curves (ROC): for PFR ≤ 300, VB 0.830, FOB 0.863; for PFR ≤ 200, VB 0.794, FOB 0.825; for PFR ≤ 100, VB 0.747, FOB 0.777 (all p <; 0.001). FOB showed 80.3% specificity, 77% sensitivity, 88.8% negative-predictive value (NPV), and 62.3% positive-predictive value (PPV) for PFR ≤ 300 and VB showed 67.2% specificity, 85.5% sensitivity, 91.3% NPV, and 53.4% PPV.Conclusions: VB provided similar injury severity scores to FOB, correlated with PFR, and reliably detected airway narrowing. VB performed during admission CT may be a useful screening tool specifically to demonstrate airway narrowing induced by SII.

KW - Computed tomography scan

KW - Fiber-optic bronchoscopy

KW - Inhalation injury

KW - Swine

KW - Virtual bronchoscopy

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U2 - 10.1016/j.burns.2014.06.007

DO - 10.1016/j.burns.2014.06.007

M3 - Article

C2 - 25112807

AN - SCOPUS:84908119661

SN - 0305-4179

VL - 40

SP - 1308

EP - 1315

JO - Burns

JF - Burns

IS - 7

ER -

Comparison of virtual bronchoscopy to fiber-optic bronchoscopy for assessment of inhalation injury severity

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Keywords

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