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Visual scoring of aortic valve calcifications on low-dose CT in lung cancer screening.

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Title: Visual scoring of aortic valve calcifications on low-dose CT in lung cancer screening.
Authors: Zhu, Yeqing1,2 (AUTHOR), Wang, Yong1,3 (AUTHOR), Gioia, William E.4 (AUTHOR), Yip, Rowena1 (AUTHOR), Jirapatnakul, Artit C.1 (AUTHOR), Chung, Michael S.1 (AUTHOR), Yankelevitz, David F.1 (AUTHOR), Henschke, Claudia I.1 (AUTHOR) Claudia.Henschke@mountsinai.org
Source: European Radiology. May2020, Vol. 30 Issue 5, p2658-2668. 11p. 1 Black and White Photograph, 7 Charts.
Subjects: Mount Sinai Hospital (New York, N.Y.), Aortic valve, Early detection of cancer, Lung cancer, Aortic stenosis, Calcification
Abstract: Objectives: To evaluate risk factors for prevalence and progression of aortic valve calcification (AVC) in lung cancer screening participants and also to assess the sensitivity and reliability of visual AVCs on low-dose CT (LDCT) for predicting aortic stenosis (AS) in high-risk smokers.Methods: We reviewed 1225 consecutive participants in annual LDCT screening for lung cancer at the Mount Sinai Hospital between 2010 and 2017. Sensitivity and specificity of moderate/severe AVC score on LDCT to identify AS on echocardiogram were calculated for 126 participants who had both within 12 months. Using regression analyses, risk factors for AVC at baseline, for progression, and for new AVC on annual rounds of screening were identified. Reliability of AVC assessment on LDCT was assessed by comparing visual AVC scores (1) with standard-dose, electrocardiography (ECG)-gated CT for 31 participants who had both within 12 months and (2) with Agatston scores of 1225 participants and by determining (3) the intra-reader agreement of 1225 participants.Results: Visual AVC scores on LDCT had substantial agreement with the severity of AS on echocardiography and substantial inter-observer and excellent intra-observer agreement. Sensitivity and specificity of moderate/severe visual AVC scores for moderate/severe AS on echocardiogram were 100% and 94%, respectively. Significant predictors for baseline AVC were male sex (OR = 2.52), age (OR10 years = 2.87), and coronary artery calcification score (OR = 1.18), the significant predictor for AVC progression after baseline was pack-years of smoking (HR10 packyears = 1.14), and significant predictors for new AVC on annual LDCT were male sex (HR = 1.51), age (HR10 years = 2.17), CAC (HR = 1.09)  and BMI (HR = 1.06).Conclusions: AVC scores on LDCT should be documented, especially in lung cancer screening program.Key Points: • LDCT screening for lung cancer provides an opportunity to identify lung cancer and cardiovascular disease in asymptomatic smokers. • Visual aortic valve calcification scores could be reliably evaluated on LDCT and had substantial agreement with the severity of aortic valve stenosis on echocardiography. • Sensitivity and specificity of moderate/severe visual AVC scores on LDCT for moderate/severe AS on echocardiogram were 100% and 94%, respectively. [ABSTRACT FROM AUTHOR]
Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Visual scoring of aortic valve calcifications on low-dose CT in lung cancer screening.
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  Data: <searchLink fieldCode="AR" term="%22Zhu%2C+Yeqing%22">Zhu, Yeqing</searchLink><relatesTo>1,2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wang%2C+Yong%22">Wang, Yong</searchLink><relatesTo>1,3</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gioia%2C+William+E%2E%22">Gioia, William E.</searchLink><relatesTo>4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Yip%2C+Rowena%22">Yip, Rowena</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Jirapatnakul%2C+Artit+C%2E%22">Jirapatnakul, Artit C.</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chung%2C+Michael+S%2E%22">Chung, Michael S.</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Yankelevitz%2C+David+F%2E%22">Yankelevitz, David F.</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Henschke%2C+Claudia+I%2E%22">Henschke, Claudia I.</searchLink><relatesTo>1</relatesTo> (AUTHOR)<i> Claudia.Henschke@mountsinai.org</i>
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  Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. May2020, Vol. 30 Issue 5, p2658-2668. 11p. 1 Black and White Photograph, 7 Charts.
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  Data: <searchLink fieldCode="DE" term="%22Mount+Sinai+Hospital+%28New+York%2C+N%2EY%2E%29%22">Mount Sinai Hospital (New York, N.Y.)</searchLink><br /><searchLink fieldCode="DE" term="%22Aortic+valve%22">Aortic valve</searchLink><br /><searchLink fieldCode="DE" term="%22Early+detection+of+cancer%22">Early detection of cancer</searchLink><br /><searchLink fieldCode="DE" term="%22Lung+cancer%22">Lung cancer</searchLink><br /><searchLink fieldCode="DE" term="%22Aortic+stenosis%22">Aortic stenosis</searchLink><br /><searchLink fieldCode="DE" term="%22Calcification%22">Calcification</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: <bold>Objectives: </bold>To evaluate risk factors for prevalence and progression of aortic valve calcification (AVC) in lung cancer screening participants and also to assess the sensitivity and reliability of visual AVCs on low-dose CT (LDCT) for predicting aortic stenosis (AS) in high-risk smokers.<bold>Methods: </bold>We reviewed 1225 consecutive participants in annual LDCT screening for lung cancer at the Mount Sinai Hospital between 2010 and 2017. Sensitivity and specificity of moderate/severe AVC score on LDCT to identify AS on echocardiogram were calculated for 126 participants who had both within 12 months. Using regression analyses, risk factors for AVC at baseline, for progression, and for new AVC on annual rounds of screening were identified. Reliability of AVC assessment on LDCT was assessed by comparing visual AVC scores (1) with standard-dose, electrocardiography (ECG)-gated CT for 31 participants who had both within 12 months and (2) with Agatston scores of 1225 participants and by determining (3) the intra-reader agreement of 1225 participants.<bold>Results: </bold>Visual AVC scores on LDCT had substantial agreement with the severity of AS on echocardiography and substantial inter-observer and excellent intra-observer agreement. Sensitivity and specificity of moderate/severe visual AVC scores for moderate/severe AS on echocardiogram were 100% and 94%, respectively. Significant predictors for baseline AVC were male sex (OR = 2.52), age (OR10 years = 2.87), and coronary artery calcification score (OR = 1.18), the significant predictor for AVC progression after baseline was pack-years of smoking (HR10 packyears = 1.14), and significant predictors for new AVC on annual LDCT were male sex (HR = 1.51), age (HR10 years = 2.17), CAC (HR = 1.09)  and BMI (HR = 1.06).<bold>Conclusions: </bold>AVC scores on LDCT should be documented, especially in lung cancer screening program.<bold>Key Points: </bold>• LDCT screening for lung cancer provides an opportunity to identify lung cancer and cardiovascular disease in asymptomatic smokers. • Visual aortic valve calcification scores could be reliably evaluated on LDCT and had substantial agreement with the severity of aortic valve stenosis on echocardiography. • Sensitivity and specificity of moderate/severe visual AVC scores on LDCT for moderate/severe AS on echocardiogram were 100% and 94%, respectively. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1007/s00330-019-06614-w
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      – Code: eng
        Text: English
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        PageCount: 11
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      – SubjectFull: Mount Sinai Hospital (New York, N.Y.)
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      – SubjectFull: Aortic valve
        Type: general
      – SubjectFull: Early detection of cancer
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      – SubjectFull: Lung cancer
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      – SubjectFull: Aortic stenosis
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