European guidance on chest CT in cystic fibrosis: hemoptysis, aspergillus, NTM, and pneumothorax

ECFS-CTN consensus (Delphi process) supports chest CT for CF patients with hemoptysis, allergic bronchopulmonary aspergillosis, or NTM-positive cultures (>2 sputum samples or 1 bronchoscopic result). Final CT justification rests with treating clinicians.

• Guidance developed via 3-step process: anonymous survey to identify priority questions, systematic literature review, then Delphi consensus validation — no prospective clinical trial data underpinning recommendations.
• Covers four special CF situations: hemoptysis, Aspergillus-related lung disease (including ABPA), non-tuberculous mycobacterial infection, and pneumothorax; specific CT thresholds defined for NTM (>2 expectorated sputum cultures or 1 positive bronchoscopic sample).
• Key limitation: recommendations are expert-consensus based with no direct comparative effectiveness data on CT-guided outcomes; applicability across varied CF care systems may differ (European perspective).

Automated summary

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