Impact of 2016 SCCT/STR guidelines for coronary artery calcium scoring of noncardiac chest CT scans on lung cancer screening CT reporting

Velangi, Pratik S.; Kenny, Barrett; Hooks, Matthew; Kanda, A.; Schertz, Kelsey; Kharoud, Harmeet; Sandhu, Gurmandeep S.; Kalra, Rajat; Allen, Tadashi; Begnaud, Abbie; Nijjar, Prabhjot S.

doi:10.1007/s10554-021-02241-z

Cited by 3 publications

(1 citation statement)

References 27 publications

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“…Importantly, CAC scoring from these non-ECG-gated exams correlates well with dedicated studies and similarly predicts adverse cardiovascular outcomes [23][24][25][26][27][28]. The Society of Cardiovascular Computed Tomography (SCCT) and the Society of Thoracic Radiology (STR) guidelines recommend the reporting of CAC on all NCCT examinations, although such evaluation and reporting of CAC on non-gated CT chest exams is only rarely performed [29,30].…”

Section: Coronary Artery Calcium Assessment and Interpretation Of Non...mentioning

confidence: 86%

Artificial Intelligence in Coronary Artery Calcium Scoring Detection and Quantification

Abdelrahman,

Shiyovich,

Huck

et al. 2024

Diagnostics

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Coronary artery calcium (CAC) is a marker of coronary atherosclerosis, and the presence and severity of CAC have been shown to be powerful predictors of future cardiovascular events. Due to its value in risk discrimination and reclassification beyond traditional risk factors, CAC has been supported by recent guidelines, particularly for the purposes of informing shared decision-making regarding the use of preventive therapies. In addition to dedicated ECG-gated CAC scans, the presence and severity of CAC can also be accurately estimated on non-contrast chest computed tomography scans performed for other clinical indications. However, the presence of such “incidental” CAC is rarely reported. Advances in artificial intelligence have now enabled automatic CAC scoring for both cardiac and non-cardiac CT scans. Various AI approaches, from rule-based models to machine learning algorithms and deep learning, have been applied to automate CAC scoring. Convolutional neural networks, a deep learning technique, have had the most successful approach, with high agreement with manual scoring demonstrated in multiple studies. Such automated CAC measurements may enable wider and more accurate detection of CAC from non-gated CT studies, thus improving the efficiency of healthcare systems to identify and treat previously undiagnosed coronary artery disease.

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Section: Coronary Artery Calcium Assessment and Interpretation Of Non...mentioning

confidence: 86%

Artificial Intelligence in Coronary Artery Calcium Scoring Detection and Quantification

Abdelrahman,

Shiyovich,

Huck

et al. 2024

Diagnostics

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Prevalence and clinical implications of coronary artery calcium scoring on non-gated thoracic computed tomography: a systematic review and meta-analysis

Osborne-Grinter,

Ali,

Williams

2023

Eur Radiol

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Objectives Coronary artery calcifications (CACs) indicate the presence of coronary artery disease. CAC can be found on thoracic computed tomography (CT) conducted for non-cardiac reasons. This systematic review and meta-analysis of non-gated thoracic CT aims to assess the clinical impact and prevalence of CAC. Methods Online databases were searched for articles assessing prevalence, demographic characteristics, accuracy and prognosis of incidental CAC on non-gated thoracic CT. Meta-analysis was performed using a random effects model. Results A total of 108 studies (113,406 patients) were included (38% female). Prevalence of CAC ranged from 2.7 to 100% (pooled prevalence 52%, 95% confidence interval [CI] 46–58%). Patients with CAC were older (pooled standardised mean difference 0.88, 95% CI 0.65–1.11, p < 0.001), and more likely to be male (pooled odds ratio [OR] 1.95, 95% CI 1.55–2.45, p < 0.001), with diabetes (pooled OR 2.63, 95% CI 1.95–3.54, p < 0.001), hypercholesterolaemia (pooled OR 2.28, 95% CI 1.33–3.93, p < 0.01) and hypertension (pooled OR 3.89, 95% CI 2.26–6.70, p < 0.001), but not higher body mass index or smoking. Non-gated CT assessment of CAC had excellent agreement with electrocardiogram-gated CT (pooled correlation coefficient 0.96, 95% CI 0.92–0.98, p < 0.001). In 51,582 patients, followed-up for 51.6 ± 27.4 months, patients with CAC had increased all cause mortality (pooled relative risk [RR] 2.13, 95% CI 1.57–2.90, p = 0.004) and major adverse cardiovascular events (pooled RR 2.91, 95% CI 2.26–3.93, p < 0.001). When CAC was present on CT, it was reported in between 18.6% and 93% of reports. Conclusion CAC is a common, but underreported, finding on non-gated CT with important prognostic implications. Clinical relevance statement Coronary artery calcium is an important prognostic indicator of cardiovascular disease. It can be assessed on non-gated thoracic CT and is a commonly underreported finding. This represents a significant population where there is a potential missed opportunity for lifestyle modification recommendations and preventative therapies. This study aims to highlight the importance of reporting incidental coronary artery calcium on non-gated thoracic CT. Key Points • Coronary artery calcification is a common finding on non-gated thoracic CT and can be reliably identified compared to gated-CT. • Coronary artery calcification on thoracic CT is associated with an increased risk of all cause mortality and major adverse cardiovascsular events. • Coronary artery calcification is frequently not reported on non-gated thoracic CT.

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Opportunistic Screening for Coronary Artery Disease: An Untapped Population Health Resource

Malik,

Sun,

Azadi

et al. 2024

Journal of the American College of Radiology

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Impact of 2016 SCCT/STR guidelines for coronary artery calcium scoring of noncardiac chest CT scans on lung cancer screening CT reporting

Cited by 3 publications

References 27 publications

Artificial Intelligence in Coronary Artery Calcium Scoring Detection and Quantification

Artificial Intelligence in Coronary Artery Calcium Scoring Detection and Quantification

Prevalence and clinical implications of coronary artery calcium scoring on non-gated thoracic computed tomography: a systematic review and meta-analysis

Opportunistic Screening for Coronary Artery Disease: An Untapped Population Health Resource

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