Korean Clinical Imaging Guideline for Hemoptysis

ABSTRACT

In 2014, the American College of Radiology announced a guideline for appropriate diagnostic approach and treatment in patients with hemoptysis, according to severity of hemoptysis and risk of lung cancer. However, in Korea many patients have pulmonary fibrosis due to previous tuberculosis or have active tuberculosis. Therefore, application of this guideline is not appropriate. The Korean Society of Radiology and Korean Society of Thoracic Radiology proposed a guideline more closely matching the real state of diagnostic approach and treatment of patients with hemoptysis in Korea. The guideline was prepared in consensus by a development committee, working party, and an advisory committee. The process of the guideline proposal was based on methodology for developing evidence-based clinical imaging guidelines: joint recommendations by the Korean Society of Radiology and National Evidence-Based Healthcare Collaborating Agency. The clinical imaging guideline for adult patients with hemoptysis is as follows. Chest radiography is an initial imaging modality to evaluate hemoptysis. Contrast enhanced chest CT is recommended in patients with two lung cancer risks (> 40 years old and > 30 packs per year smoking history), moderate hemoptysis (> 30 cc/24 hours) or recurrent hemoptysis. Contrast enhanced chest CT is also recommended for patients with massive hemoptysis (> 400 mL/24 hours) without cardiopulmonary compromise.