Thirty-three of the 35 patients with cryptogenic hemoptysis were successfully treated with BAE, and 97% of these patients remained free of hemoptysis at 20 months. The authors reported that there was no correlation between severity of hemoptysis and the diameter of the embolized bronchial artery. These results were not compared to the patients with a known cause of hemoptysis. CT Chest with IV Contrast As with massive hemoptysis, CT with IV contrast is the primary modality to determine hemoptysis etiology. Thirumaran et al [44], in an early study establishing CT as a diagnostic tool for nonmassive hemoptysis, retrospectively studied 270 patients with hemoptysis and a normal chest radiograph, with 94% reporting mild hemoptysis, and commonly with repeated episodes. Although the most common cause of hemoptysis was acute bronchitis (63%), the second most common cause was a respiratory tract neoplasm, the majority of which was a lung primary malignancy (n = 22/270). Lee et al [49] reported performing CT examinations on all 221 patients evaluated for hemoptysis, 48% with nonmassive hemoptysis and 52% with massive hemoptysis. Interestingly, both cohorts had similar etiologies, with bronchiectasis followed by active tuberculosis as the leading causes for hemoptysis, and CT proved to be the superior diagnostic imaging modality over bronchoscopy and arteriography for identifying the cause of hemoptysis. CT with IV contrast is now the established imaging modality to determine the etiology of nonmassive hemoptysis, and therefore, there are no recent publications comparing its efficacy to other imaging modalities. CT Chest without IV Contrast As discussed in Variant 1, CT chest without IV contrast is only warranted in the diagnosis of hemoptysis in patients with poor renal function or life-threatening contrast allergy. The limited number of studies reviewing the utility of
Hemoptysis. Thirty-three of the 35 patients with cryptogenic hemoptysis were successfully treated with BAE, and 97% of these patients remained free of hemoptysis at 20 months. The authors reported that there was no correlation between severity of hemoptysis and the diameter of the embolized bronchial artery. These results were not compared to the patients with a known cause of hemoptysis. CT Chest with IV Contrast As with massive hemoptysis, CT with IV contrast is the primary modality to determine hemoptysis etiology. Thirumaran et al [44], in an early study establishing CT as a diagnostic tool for nonmassive hemoptysis, retrospectively studied 270 patients with hemoptysis and a normal chest radiograph, with 94% reporting mild hemoptysis, and commonly with repeated episodes. Although the most common cause of hemoptysis was acute bronchitis (63%), the second most common cause was a respiratory tract neoplasm, the majority of which was a lung primary malignancy (n = 22/270). Lee et al [49] reported performing CT examinations on all 221 patients evaluated for hemoptysis, 48% with nonmassive hemoptysis and 52% with massive hemoptysis. Interestingly, both cohorts had similar etiologies, with bronchiectasis followed by active tuberculosis as the leading causes for hemoptysis, and CT proved to be the superior diagnostic imaging modality over bronchoscopy and arteriography for identifying the cause of hemoptysis. CT with IV contrast is now the established imaging modality to determine the etiology of nonmassive hemoptysis, and therefore, there are no recent publications comparing its efficacy to other imaging modalities. CT Chest without IV Contrast As discussed in Variant 1, CT chest without IV contrast is only warranted in the diagnosis of hemoptysis in patients with poor renal function or life-threatening contrast allergy. The limited number of studies reviewing the utility of