Recent literature shows a trend of more commonly treating patients with nonmassive recurrent hemoptysis with interventional or surgical procedures rather than conservative therapies compared with patients with an initial presentation of nonmassive hemoptysis. Therefore, imaging recommendations differ between patients initially presenting with nonmassive hemoptysis and patients presenting with recurrent nonmassive hemoptysis. Hemoptysis outcomes were due to sequelae from BAE or sequelae from recurrent hemoptysis. Of the handful of studies documenting lack of clinically significant change following BAE, Tom et al [4] specifically studied long-term clinical parameters of patients prior to and following BAE. Of the 69 patients with hemoptysis initially treated with BAE, 17 patients had at least 5 years of clinical data before and 5 years of clinical data after the initial BAE. The authors identified that pulmonary function parameters declined at the same rate prior to the initial BAE as they had following BAE. CT Chest with IV Contrast Patients with recurrent hemoptysis typically have a known cause. Bronchiectasis due to repeated or indolent infection is the most common cause for recurrent hemoptysis in most large studies. In patients with cystic fibrosis, for example, recurrent hemoptysis may be an indicator of acute infection [60], and CT may not be indicated. There are limited data evaluating the utility of CT chest with IV contrast in the setting of a known cause of hemoptysis. CT Chest without IV Contrast There is no relevant literature supporting the use of CT chest without IV contrast in the assessment of recurrent hemoptysis. CT Chest without and with IV Contrast There is no relevant literature supporting the use of CT chest without IV contrast prior to a CT performed with IV contrast in patients with recurrent hemoptysis. CTA Chest There are no recent data comparing the diagnostic advantages between routine CT with IV contrast with CTA in patients with recurrent hemoptysis.
Hemoptysis. Recent literature shows a trend of more commonly treating patients with nonmassive recurrent hemoptysis with interventional or surgical procedures rather than conservative therapies compared with patients with an initial presentation of nonmassive hemoptysis. Therefore, imaging recommendations differ between patients initially presenting with nonmassive hemoptysis and patients presenting with recurrent nonmassive hemoptysis. Hemoptysis outcomes were due to sequelae from BAE or sequelae from recurrent hemoptysis. Of the handful of studies documenting lack of clinically significant change following BAE, Tom et al [4] specifically studied long-term clinical parameters of patients prior to and following BAE. Of the 69 patients with hemoptysis initially treated with BAE, 17 patients had at least 5 years of clinical data before and 5 years of clinical data after the initial BAE. The authors identified that pulmonary function parameters declined at the same rate prior to the initial BAE as they had following BAE. CT Chest with IV Contrast Patients with recurrent hemoptysis typically have a known cause. Bronchiectasis due to repeated or indolent infection is the most common cause for recurrent hemoptysis in most large studies. In patients with cystic fibrosis, for example, recurrent hemoptysis may be an indicator of acute infection [60], and CT may not be indicated. There are limited data evaluating the utility of CT chest with IV contrast in the setting of a known cause of hemoptysis. CT Chest without IV Contrast There is no relevant literature supporting the use of CT chest without IV contrast in the assessment of recurrent hemoptysis. CT Chest without and with IV Contrast There is no relevant literature supporting the use of CT chest without IV contrast prior to a CT performed with IV contrast in patients with recurrent hemoptysis. CTA Chest There are no recent data comparing the diagnostic advantages between routine CT with IV contrast with CTA in patients with recurrent hemoptysis.