ACR Appropriateness Criteria® Hemoptysis - PubMed (original) (raw)
Practice Guideline
. 2020 May;17(5S):S148-S159.
doi: 10.1016/j.jacr.2020.01.043.
Kathryn M Olsen 1, Shawdi Manouchehr-Pour 2, Edwin F Donnelly 3, Travis S Henry 4, Mark F Berry 5, Phillip M Boiselle 6, Patrick M Colletti 7, Nicholas E Harrison 8, Christopher T Kuzniewski 9, Archana T Laroia 10, Fabien Maldonado 11, Jason W Pinchot 12, Constantine A Raptis 13, Kyungran Shim 14, Betty C Tong 15, Carol C Wu 16, Jeffrey P Kanne 17
Affiliations
- PMID: 32370959
- DOI: 10.1016/j.jacr.2020.01.043
Practice Guideline
ACR Appropriateness Criteria® Hemoptysis
Expert Panel on Thoracic Imaging et al. J Am Coll Radiol. 2020 May.
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.
Keywords: AUC; Appropriate Use Criteria; Appropriateness Criteria; Diagnostic imaging; Massive hemoptysis; Medical imaging; Nonmassive hemoptysis; Recurrent hemoptysis.
Copyright © 2020 American College of Radiology. Published by Elsevier Inc. All rights reserved.
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