 Greetings to all. My name is Dr. Maya Rizugurka, Radiology Resurance, training in KNM 71 in Hospital Mumbai. Today, I'm presenting paper on the topic of virtual bronchoscopy state of the art and future needs. MD City has been a revolution in city technology with its inherent space and ability to acquire thinner section, polymetrally. Modern MD City scanners enable post-processing multiple reconstruction in orthogonal and non-orthogonal plane, including curve planes with near isotropic revolution. Improves software and advanced workstation enable radiologists to post-process data set in 3D for volume render mode, which supplements information available on the excellent MPR images, increasing the diagnostic accuracy manifolds. Virtual bronchoscopy essentially is such a post-processing technique, which creates a de-rendition of the inner surface of the turquoise bronchial tree, simulating envelopment as put visible on the actual bronchoscopy. Virtual bronchoscopy has gained a lot of quality and diagnostic potential. It is important to understand the pulse and response of the virtual bronchoscopy, so that this technique can be optimally utilized. In the following illustrative cases, I led the utility of virtual bronchoscopy in the diagnosis of arid turquoise bronchial pathologies encountered. A 35-year-old male patient presenting with new onset dyspnea, over one year with pulmonary function test, demonstrating a restrictive pattern. X-rays, PN, lateral view findings went unnoticed initially. CT-Torex was done one month later because of non-resolution of the symptoms. Coronel CT of this patient demonstrated an ill-defined homogenous mass in the list still left mainstream bronchoscopy. On virtual bronchoscopy, we can see interluminal growth, which is just proximal at the before bifurcation of the left mainstream bronchoscopy. These findings are confirmed on the flexible bronchoscopy. This is the endobronchial growth, which is seen just proximal to the bifurcation of the left mainstream bronchoscopy. Moving to the next case, this is a 65-year-old male complaint of pantheism and hoarseness of voice. See is it in a suggestive of ill-defined mass involving the vocal cords and data commissure of plant-ending sinus is seen within the mass. This is the mass. This is the sinus tract. Going to the next case, a two-year-old female child came with the complaints of feeding difficulty and recurrent aspiration. CT and virtual bronchoscopy are of benefit in preoperative planning of such patients. On CT, we can see there is connection between the trachea and the esophagus, such as due of tracheoesophageal fistula on virtual bronchoscopy. This is the fistula, esophagus, trachea. This is the carina, left mainstream bronchus, right mainstream bronchus. Moving to the next case, this is a 65-year-old female patient with past history of prolonged division. There is tracheal narrowing noted on CT on virtual bronchoscopy. There is stenosis of the trachea. This patient underwent tracheostomy afterwards. This is another case showing subglottic stenosis. This is epiglottis, vocal cords. This is the stenotic part. These are images of the same. Virtual bronchoscopy is useful in the evaluation of patient with significant stenosis of the respiratory tract as a result of the broad spectrum pathological states. Virtual bronchoscopy is particularly suitable in some diseases of the chest as bronchosephageal fistula after lung transplantation and ostomosis, suspected aspiration of a foreign body and respiratory disabilities. Virtual bronchoscopy enables accurately to inspect the lumen and the diameter of the bronchial tree to assess the stenosis of the airway to visualize remote terminate lesions. The images look very similar to what's seen with fibro bronchoscopy. The intravenous introduction of the contrast medium does not affect the quality of the virtual bronchoscopy images. Moreover, it is proven that virtual bronchoscopy can be useful for determining the appropriateness of the endocrine procedure such as extension, placement of a stent and laser ablation of the endocrine tumours. The main limitation of the virtual bronchoscopy refers to inability to reliably avail the mucus surface of the airways. Therefore, virtual bronchoscopy may not be used for routine monitoring of a patient at high risk of developing malignant diseases of the respiratory tract. These are some advantages of the virtual bronchoscopy. It is non-invasive procedure that can visualize areas inaccessible to the flexible bronchoscope. Virtual bronchoscopy helps in the evaluation of the bronchial stenosis or obstruction caused by both endoluminal pathology and external compression. Virtual bronchoscopy helps in planning of stent placement before the procedure to evaluate surgical suture after lung transplantation, lobectomy or pneumonectomy, to evaluate anatomical malformation and bronchial variants. This advantage of virtual bronchoscopy is that it does not allow detection of the subtle mucus alleges. Because virtual bronchoscopy is an imaging technique based on CT, for CT it is always necessary for the patient to expose to the radiation. Virtual bronchoscopy depends on the availability and use of the hardware, CT and software. Virtual bronchoscopy will never replace fibro bronchoscopy but in some cases it can help fibroscopy directly and sometimes it can give additional information. These are my references. Thank you.