Prediction of hemoptysis in patients with anomalous systemic arterial supply to normal basal segments of the lower lobe using a combination of CT features and clinical materials.

BACKGROUND

Anomalous systemic arterial supply to the normal basal segments of the lower lobe (ASALL) is a rare anomaly with a common complication of hemoptysis. To estimate the risk of hemoptysis, this study aims to investigate the value of contrast-enhanced computed tomography (CT) and construct a risk-scoring model based on radiological features and clinical materials of patients with ASALL.

METHODS

Forty-three eligible individuals (17 women and 26 males), who underwent multiphase contrast-enhanced CT, were included in this study. Hemoptysis was predicted by combined systemic arterial features (C) and combined demographic and radiological features (C). Potential hemoptysis predictors were identified using multivariate regression analysis. A receiver operating characteristic (ROC) curve analysis was used to assess the prediction efficiency. The coefficient of regression model was used to build a combined risk scoring (C) model for hemoptysis. The decision curve analysis (DCA) was performed to evaluate the clinical usefulness of the risk-scoring model.

RESULTS

Hemoptysis was present in 17 (39.5%) ASALL patients. The areas under the curve (AUCs) for the predicted performance of C and C were 0.869 and 0.890, respectively. Independent predictors generated a scoring model using the formula C = 3 × age + 3 × sex + 4 × [ground glass opacity (GGO)] + 3 × (C >0.522). The prediction performance of this model was displayed with an AUC of 0.939. This scoring model was demonstrated to be significantly preferable to C (P=0.046) and C (P=0.02) by the Hanley and McNeil test. The DCA showed that the C model was more beneficial when the threshold probability was between 5% and 92%.

CONCLUSIONS

The scoring model offers a viable method for evaluating the risk of hemoptysis in patients with ASALL by combining radiological and clinical data.