Impact of Slice Thickness on the Predictive Value of Lung Cancer Screening Computed Tomography in the Evaluation of Coronary Artery Calcification

Autor: Anastassia Y. Gorvitovskaia, Alan R. Morrison, Jared L. Christensen, Wen-Chih Wu, Jerome P. Watts, Esseim Sharma, Gaurav Choudhary, Maen Assali, Jade Neverson
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
Lung Neoplasms
Computed tomography
Coronary Artery Disease
030204 cardiovascular system & hematology
Coronary Angiography
030218 nuclear medicine & medical imaging
Imaging
Electrocardiography
0302 clinical medicine
Interquartile range
Cause of Death
Vascular Disease
Medicine
Coronary Heart Disease
Early Detection of Cancer
Original Research
medicine.diagnostic_test
Middle Aged
Predictive value
Survival Rate
symbols
Female
Cardiology and Cardiovascular Medicine
Algorithms
Slice thickness
coronary computed tomography
03 medical and health sciences
symbols.namesake
Predictive Value of Tests
Multidetector Computed Tomography
Humans
Vascular Calcification
lung cancer screening computed tomography
Aged
Retrospective Studies
Receiver operating characteristic
business.industry
Computerized Tomography (CT)
Rhode Island
computed tomography
Atherosclerosis
Pearson product-moment correlation coefficient
coronary artery calcification
ROC Curve
Coronary artery calcification
business
Nuclear medicine
Lung cancer screening
Follow-Up Studies
Zdroj: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
ISSN: 2047-9980
Popis: Background Image reconstruction thickness may impact quantitative coronary artery calcium scoring (CACS) from lung cancer screening computed tomography (LCSCT), limiting its application in practice. Methods and Results We evaluated Agatston‐based quantitative CACS from 1.25‐mm LCSCT and cardiac computed tomography for agreement in 87 patients. We then evaluated Agatston‐based quantitative CACS from 1.25‐, 2.5‐, and 5.0‐mm slice thickness LCSCT for agreement in 258 patients. Secondary analysis included the impact of slice thickness on predictive value of 4‐year outcomes. Median age of patients who underwent 1.25‐mm LCSCT and cardiac computed tomography was 63 years (interquartile interval, 57, 68). CACS from 1.25‐mm LCSCT and cardiac computed tomography demonstrated a strong Pearson correlation, R=0.9770 (0.965, 0.985), with good agreement. The receiver operating characteristic curve areas under the curve for cardiac computed tomography and LCSCT were comparable at 0.8364 (0.6628, 1.01) and 0.8208 (0.6431, 0.9985), respectively ( P =0.733). Median age of patients who underwent LCSCT with 3 slice thicknesses was 66 years (interquartile interval, 63, 73). Compared with CACS from 1.25‐mm scans, CACS from 2.5‐ and 5.0‐mm scans demonstrated strong Pearson correlations, R=0.9949 (0.9935, 0.996) and R=0.9478 (0.9338, 0.959), respectively, though bias was largely negative for 5.0‐mm scans. Receiver operating characteristic curve areas under the curve for 1.25‐, 2.5‐, and 5.0‐mm scans were comparable at 0.7040 (0.6307, 0.7772), 0.7063 (0.6327, 0.7799), and 0.7194 (0.6407, 0.7887), respectively ( P =0.6487). When using individualized high‐risk thresholds derived from respective receiver operating characteristic curves, all slice thicknesses demonstrated similar prognostic value. Conclusions Slice thickness is an important consideration when interpreting Agatston CACS from LCSCTs. Despite the absence of ECG gating, it appears reasonable to report CACS from either 1.25‐ or 2.5‐mm slice thickness LCSCT to help stratify cardiovascular risk. Conversely, 5.0‐mm scans largely underidentify calcium, limiting practical use within the established CACS values used to categorize cardiovascular risk.
Databáze: OpenAIRE
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