Coronary calcium score and emphysema extent on different CT radiation dose protocols in lung cancer screening.

IF 4.7 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Radiology Pub Date : 2025-07-01 Epub Date: 2024-12-20 DOI:10.1007/s00330-024-11254-w

Roberta Eufrasia Ledda, Gianluca Milanese, Maurizio Balbi, Federica Sabia, Camilla Valsecchi, Margherita Ruggirello, Andrea Ciuni, Giulia Tringali, Nicola Sverzellati, Alfonso Vittorio Marchianò, Ugo Pastorino

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引用次数: 0

Abstract

Objectives: To assess the consistency of automated measurements of coronary artery calcification (CAC) burden and emphysema extent on computed tomography (CT) images acquired with different radiation dose protocols in a lung cancer screening (LCS) population.

Materials and methods: The patient cohort comprised 361 consecutive screenees who underwent a low-dose CT (LDCT) scan and an ultra-low-dose CT (ULDCT) scan at an incident screening round. Exclusion criteria for CAC measurements were software failure and previous history of CVD, including coronary stenting, whereas for emphysema assessment, software failure only. CT images were retrospectively analyzed by a fully automated AI software for CAC scoring, using three predefined Agatston score categories (0-99, 100-399, and ≥ 400), and emphysema quantification, using the percentage of low attenuation areas (%LAA). Demographic and clinical data were obtained from the written questionnaire completed by each participant at the first visit. Agreement for CAC and %LAA categories was measured by the k-Cohen Index with Fleiss-Cohen weights (K_w) and Intraclass Correlation Coefficient (ICC) with 95% Confidence Interval (CI).

Results: An overlap of CAC strata was observed in 275/327 (84%) volunteers, with an almost perfect agreement (K_w = 0.86, 95% CI 0.82-0.90; ICC = 0.86, 95% CI 0.79-0.90), while an overlap of %LAA strata was found in 204/356 (57%) volunteers, with a moderate agreement (K_w = 0.57, 95% CI 0.51-0.63; ICC = 0.57, 95% CI 0.21-0.75).

Conclusion: Automated CAC quantification on ULDCT seems feasible, showing similar results to those obtained on LDCT, while the quantification of emphysema tended to be overestimated on ULDCT images.

Key points: Question Evidence demonstrating that coronary artery calcification and emphysema can be automatedly quantified on ultra-low-dose chest CT is still awaited. Findings Coronary artery calcification and emphysema measurements were similar among different CT radiation dose protocols; their automated quantification is feasible on ultra-low-dose CT. Clinical relevance Ultra-low-dose CT-based LCS might offer an opportunity to improve the secondary prevention of cardiovascular and respiratory diseases through automated quantification of both CAC burden and emphysema extent.

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冠状动脉钙化评分及肺气肿程度对不同CT辐射剂量肺癌筛查的影响。

目的：评估在肺癌筛查（LCS）人群中，不同辐射剂量方案获得的计算机断层扫描（CT）图像中冠状动脉钙化（CAC）负荷和肺气肿程度的自动测量的一致性。材料和方法：患者队列包括361名连续筛查的患者，他们在一次事件筛查中接受了低剂量CT （LDCT）扫描和超低剂量CT （ULDCT）扫描。CAC测量的排除标准为软件故障和既往心血管疾病史，包括冠状动脉支架植入，而肺气肿评估仅为软件故障。CT图像回顾性分析采用全自动人工智能软件进行CAC评分，使用三个预定义的Agatston评分类别（0-99、100-399和≥400），并使用低衰减区域百分比（%LAA）进行肺气肿量化。每位参与者在第一次访问时完成的书面问卷中获得了人口统计学和临床数据。采用具有Fleiss-Cohen权重（Kw）的k-Cohen指数和具有95%置信区间（CI）的类内相关系数（ICC）来衡量CAC和%LAA类别的一致性。结果：在275/327（84%）志愿者中观察到CAC层重叠，几乎完全一致(Kw = 0.86, 95% CI 0.82-0.90；ICC = 0.86, 95% CI 0.79-0.90)，而在209 /356名（57%）志愿者中发现了%LAA地层重叠，具有中等一致性(Kw = 0.57, 95% CI 0.51-0.63；Icc = 0.57, 95% ci 0.21-0.75)。结论：在ULDCT上自动定量CAC似乎是可行的，其结果与LDCT相似，但在ULDCT图像上对肺气肿的定量往往被高估。超低剂量胸部CT可自动量化冠状动脉钙化和肺气肿的证据尚待证实。发现不同CT辐射剂量下冠状动脉钙化和肺气肿测量值相似；在超低剂量CT上自动定量是可行的。基于超低剂量ct的LCS可能通过自动量化CAC负担和肺气肿程度，为改善心血管和呼吸系统疾病的二级预防提供机会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Radiology 医学-核医学

CiteScore

11.60

自引率

8.50%

发文量

874

审稿时长

2-4 weeks

期刊介绍： European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field. This is the Journal of the European Society of Radiology, and the official journal of a number of societies. From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.