Pulmonary emphysema and coronary artery calcifications at baseline LDCT and long-term mortality in smokers and former smokers of the ITALUNG screening trial.
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| Title: | Pulmonary emphysema and coronary artery calcifications at baseline LDCT and long-term mortality in smokers and former smokers of the ITALUNG screening trial. |
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| Authors: | Mascalchi, Mario1,2,3 mario.mascalchi@unifi.it, Romei, Chiara4, Marzi, Chiara5, Diciotti, Stefano6, Picozzi, Giulia2, Pistelli, Francesco7, Zappa, Marco2, Paci, Eugenio2, Carozzi, Francesca8, Gorini, Giuseppe2, Falaschi, Fabio4, Deliperi, Anna Lisa4, Camiciottoli, Gianna1, Carrozzi, Laura7, Puliti, Donella2 |
| Source: | European Radiology. May2023, Vol. 33 Issue 5, p3115-3123. 9p. 3 Charts, 1 Graph. |
| Subjects: | Coronary artery calcification, Pulmonary emphysema, Ex-smokers, Medical screening, Mortality |
| Abstract: | Objectives: Cardiovascular disease (CVD), lung cancer (LC), and respiratory diseases are main causes of death in smokers and former smokers undergoing low-dose computed tomography (LDCT) for LC screening. We assessed whether quantification of pulmonary emphysematous changes at baseline LDCT has a predictive value concerning long-term mortality. Methods: In this longitudinal study, we assessed pulmonary emphysematous changes with densitometry (volume corrected relative area below − 950 Hounsfield units) and coronary artery calcifications (CAC) with a 0–3 visual scale in baseline LDCT of 524 participants in the ITALUNG trial and analyzed their association with mortality after 13.6 years of follow-up using conventional statistics and a machine learning approach. Results: Pulmonary emphysematous changes were present in 32.3% of subjects and were mild (6% ≤ RA950 ≤ 9%) in 14.9% and moderate-severe (RA950 > 9%) in 17.4%. CAC were present in 67% of subjects (mild in 34.7%, moderate-severe in 32.2%). In the follow-up, 81 (15.4%) subjects died (20 of LC, 28 of other cancers, 15 of CVD, 4 of respiratory disease, and 14 of other conditions). After adjusting for age, sex, smoking history, and CAC, moderate-severe emphysema was significantly associated with overall (OR 2.22; 95CI 1.34–3.70) and CVD (OR 3.66; 95CI 1.21–11.04) mortality. Machine learning showed that RA950 was the best single feature predictive of overall and CVD mortality. Conclusions: Moderate-severe pulmonary emphysematous changes are an independent predictor of long-term overall and CVD mortality in subjects participating in LC screening and should be incorporated in the post-test calculation of the individual mortality risk profile. Key Points: • Densitometry allows quantification of pulmonary emphysematous changes in low-dose CT examinations for lung cancer screening. • Emphysematous lung density changes are an independent predictor of long-term overall and cardio-vascular disease mortality in smokers and former smokers undergoing screening. • Emphysematous changes quantification should be included in the post-test calculation of the individual mortality risk profile. [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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| Header | DbId: egs DbLabel: Engineering Source An: 163255742 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Pulmonary emphysema and coronary artery calcifications at baseline LDCT and long-term mortality in smokers and former smokers of the ITALUNG screening trial. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Mascalchi%2C+Mario%22">Mascalchi, Mario</searchLink><relatesTo>1,2,3</relatesTo><i> mario.mascalchi@unifi.it</i><br /><searchLink fieldCode="AR" term="%22Romei%2C+Chiara%22">Romei, Chiara</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Marzi%2C+Chiara%22">Marzi, Chiara</searchLink><relatesTo>5</relatesTo><br /><searchLink fieldCode="AR" term="%22Diciotti%2C+Stefano%22">Diciotti, Stefano</searchLink><relatesTo>6</relatesTo><br /><searchLink fieldCode="AR" term="%22Picozzi%2C+Giulia%22">Picozzi, Giulia</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Pistelli%2C+Francesco%22">Pistelli, Francesco</searchLink><relatesTo>7</relatesTo><br /><searchLink fieldCode="AR" term="%22Zappa%2C+Marco%22">Zappa, Marco</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Paci%2C+Eugenio%22">Paci, Eugenio</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Carozzi%2C+Francesca%22">Carozzi, Francesca</searchLink><relatesTo>8</relatesTo><br /><searchLink fieldCode="AR" term="%22Gorini%2C+Giuseppe%22">Gorini, Giuseppe</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Falaschi%2C+Fabio%22">Falaschi, Fabio</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Deliperi%2C+Anna+Lisa%22">Deliperi, Anna Lisa</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Camiciottoli%2C+Gianna%22">Camiciottoli, Gianna</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Carrozzi%2C+Laura%22">Carrozzi, Laura</searchLink><relatesTo>7</relatesTo><br /><searchLink fieldCode="AR" term="%22Puliti%2C+Donella%22">Puliti, Donella</searchLink><relatesTo>2</relatesTo> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. May2023, Vol. 33 Issue 5, p3115-3123. 9p. 3 Charts, 1 Graph. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Coronary+artery+calcification%22">Coronary artery calcification</searchLink><br /><searchLink fieldCode="DE" term="%22Pulmonary+emphysema%22">Pulmonary emphysema</searchLink><br /><searchLink fieldCode="DE" term="%22Ex-smokers%22">Ex-smokers</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+screening%22">Medical screening</searchLink><br /><searchLink fieldCode="DE" term="%22Mortality%22">Mortality</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Objectives: Cardiovascular disease (CVD), lung cancer (LC), and respiratory diseases are main causes of death in smokers and former smokers undergoing low-dose computed tomography (LDCT) for LC screening. We assessed whether quantification of pulmonary emphysematous changes at baseline LDCT has a predictive value concerning long-term mortality. Methods: In this longitudinal study, we assessed pulmonary emphysematous changes with densitometry (volume corrected relative area below − 950 Hounsfield units) and coronary artery calcifications (CAC) with a 0–3 visual scale in baseline LDCT of 524 participants in the ITALUNG trial and analyzed their association with mortality after 13.6 years of follow-up using conventional statistics and a machine learning approach. Results: Pulmonary emphysematous changes were present in 32.3% of subjects and were mild (6% ≤ RA950 ≤ 9%) in 14.9% and moderate-severe (RA950 > 9%) in 17.4%. CAC were present in 67% of subjects (mild in 34.7%, moderate-severe in 32.2%). In the follow-up, 81 (15.4%) subjects died (20 of LC, 28 of other cancers, 15 of CVD, 4 of respiratory disease, and 14 of other conditions). After adjusting for age, sex, smoking history, and CAC, moderate-severe emphysema was significantly associated with overall (OR 2.22; 95CI 1.34–3.70) and CVD (OR 3.66; 95CI 1.21–11.04) mortality. Machine learning showed that RA950 was the best single feature predictive of overall and CVD mortality. Conclusions: Moderate-severe pulmonary emphysematous changes are an independent predictor of long-term overall and CVD mortality in subjects participating in LC screening and should be incorporated in the post-test calculation of the individual mortality risk profile. Key Points: • Densitometry allows quantification of pulmonary emphysematous changes in low-dose CT examinations for lung cancer screening. • Emphysematous lung density changes are an independent predictor of long-term overall and cardio-vascular disease mortality in smokers and former smokers undergoing screening. • Emphysematous changes quantification should be included in the post-test calculation of the individual mortality risk profile. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab 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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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1007/s00330-023-09504-4 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 9 StartPage: 3115 Subjects: – SubjectFull: Coronary artery calcification Type: general – SubjectFull: Pulmonary emphysema Type: general – SubjectFull: Ex-smokers Type: general – SubjectFull: Medical screening Type: general – SubjectFull: Mortality Type: general Titles: – TitleFull: Pulmonary emphysema and coronary artery calcifications at baseline LDCT and long-term mortality in smokers and former smokers of the ITALUNG screening trial. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Mascalchi, Mario – PersonEntity: Name: NameFull: Romei, Chiara – PersonEntity: Name: NameFull: Marzi, Chiara – PersonEntity: Name: NameFull: Diciotti, Stefano – PersonEntity: Name: NameFull: Picozzi, Giulia – PersonEntity: Name: NameFull: Pistelli, Francesco – PersonEntity: Name: NameFull: Zappa, Marco – PersonEntity: Name: NameFull: Paci, Eugenio – PersonEntity: Name: NameFull: Carozzi, Francesca – PersonEntity: Name: NameFull: Gorini, Giuseppe – PersonEntity: Name: NameFull: Falaschi, Fabio – PersonEntity: Name: NameFull: Deliperi, Anna Lisa – PersonEntity: Name: NameFull: Camiciottoli, Gianna – PersonEntity: Name: NameFull: Carrozzi, Laura – PersonEntity: Name: NameFull: Puliti, Donella IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 05 Text: May2023 Type: published Y: 2023 Identifiers: – Type: issn-print Value: 09387994 Numbering: – Type: volume Value: 33 – Type: issue Value: 5 Titles: – TitleFull: European Radiology Type: main |
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