ACR Appropriateness Criteria® Hemoptysis.

Authors

Kathryn M Olsen
Shawdi Manouchehr-Pour
Edwin F Donnelly
Travis S Henry
Mark F Berry
Phillip M Boiselle
Patrick M Colletti
Nicholas E Harrison, Beaumont Health
Christopher T Kuzniewski
Archana T Laroia
Fabien Maldonado
Jason W Pinchot
Constantine A Raptis
Kyungran Shim
Betty C Tong
Carol C Wu
Jeffrey P Kanne

Document Type

Article

Publication Date

5-1-2020

Publication Title

Journal of the American College of Radiology : JACR

Abstract

Hemoptysis, the expectoration of blood, ranges in severity from nonmassive to massive. This publication reviews the literature on the imaging and treatment of hemoptysis. Based on the literature, the imaging recommendations for massive hemoptysis are both a chest radiograph and CT with contrast or CTA with contrast. Bronchial artery embolization is also recommended in the majority of cases. In nonmassive hemoptysis, both a chest radiograph and CT with contrast or CTA with contrast is recommended. Bronchial artery embolization is becoming more commonly utilized, typically in the setting of failed medical therapy. Recurrent hemoptysis, defined as hemoptysis that recurs following initially successful cessation of hemoptysis, is best reassessed with a chest radiograph and either CT with contrast or CTA with contrast. Bronchial artery embolization is increasingly becoming the treatment of choice in recurrent hemoptysis, with the exception of infectious causes such as in cystic fibrosis. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

Volume

17

Issue

5S

First Page

148

Last Page

159

Recommended Citation

Expert Panel on Thoracic Imaging, Olsen KM, Manouchehr-Pour S, Donnelly EF, Henry TS, Berry MF, Boiselle PM, Colletti PM, Harrison NE, Kuzniewski CT, Laroia AT, Maldonado F, Pinchot JW, Raptis CA, Shim K, Tong BC, Wu CC, Kanne JP. ACR Appropriateness Criteria® Hemoptysis. J Am Coll Radiol. 2020 May;17(5S):S148-S159. doi: 10.1016/j.jacr.2020.01.043. PMID: 32370959.

DOI

10.1016/j.jacr.2020.01.043

ISSN

1558-349X

PubMed ID

32370959