Correlation of the Imaging Findings with Bronchoscopic Findings for the Detection of Endobronchial Lesions: A Systematic Review and Meta-Analysis

Background: The purpose of this systematic review was to compare the diagnostic accuracy of axial thoracic CT, other imaging techniques and image reconstruction algorithms with the endoscopic findings of Fiberopptic Bronchoscopy (FOB), in patients with newly detected endobronchial lesions. Methods: A systematic review of the literature for retrospective and prospective studies was performed. Articles considered included patients with endobronchial stenosis that were subjected to axial Computed Tomography of the chest with or without an image reconstruction technique, and Fiberoptic Bronchoscopy. Results: 10 studies (6 prospective/4 retrospective) that were published in PubMed or CancerLit met the inclusion criteria. A total number of 633 patients were involved in the studies and an additional number of 53 patients were included as controls. All the patients were subjected to Fiberoptic Bronchoscopy (FOB) and imaging of the chest. The meta-analysis showed a high sensitivity for most imaging techniques, comparable with this of Fiberoptic Bronchoscopy, but with a significant Negative Predictive Value. Conclusion: Even though the imaging techniques are a useful, fast and safe modality for the detection of endobronchial lesions, the high negative predictive value raises a concern on their sufficiency for the exclusion of lung cancer on high risk patients.