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Chen J, Meng T, Xu J, Ooi JD, Eggenhuizen PJ, Liu W, Li F, Wu X, Sun J, Zhang H, Zhou YO, Luo H, Xiao X, Pei Y, Li W, Zhong Y. Development of a radiomics nomogram to predict the treatment resistance of Chinese MPO-AAV patients with lung involvement: a two-center study. Front Immunol 2023; 14:1084299. [PMID: 37503353 PMCID: PMC10369051 DOI: 10.3389/fimmu.2023.1084299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 06/19/2023] [Indexed: 07/29/2023] Open
Abstract
Background Previous studies from our group and other investigators have shown that lung involvement is one of the independent predictors for treatment resistance in patients with myeloperoxidase (MPO)-anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (MPO-AAV). However, it is unclear which image features of lung involvement can predict the therapeutic response in MPO-AAV patients, which is vital in decision-making for these patients. Our aim was to develop and validate a radiomics nomogram to predict treatment resistance of Chinese MPO-AAV patients based on low-dose multiple slices computed tomography (MSCT) of the involved lung with cohorts from two centers. Methods A total of 151 MPO-AAV patients with lung involvement (MPO-AAV-LI) from two centers were enrolled. Two different models (Model 1: radiomics signature; Model 2: radiomics nomogram) were built based on the clinical and MSCT data to predict the treatment resistance of MPO-AAV with lung involvement in training and test cohorts. The performance of the models was assessed using the area under the curve (AUC). The better model was further validated. A nomogram was constructed and evaluated by DCA and calibration curves, which further tested in all enrolled data and compared with the other model. Results Model 2 had a higher predicting ability than Model 1 both in training (AUC: 0.948 vs. 0.824; p = 0.039) and test cohorts (AUC: 0.913 vs. 0.898; p = 0.043). As a better model, Model 2 obtained an excellent predictive performance (AUC: 0.929; 95% CI: 0.827-1.000) in the validation cohort. The DCA curve demonstrated that Model 2 was clinically feasible. The calibration curves of Model 2 closely aligned with the true treatment resistance rate in the training (p = 0.28) and test sets (p = 0.70). In addition, the predictive performance of Model 2 (AUC: 0.929; 95% CI: 0.875-0.964) was superior to Model 1 (AUC: 0.862; 95% CI: 0.796-0.913) and serum creatinine (AUC: 0.867; 95% CI: 0.802-0.917) in all patients (all p< 0.05). Conclusion The radiomics nomogram (Model 2) is a useful, non-invasive tool for predicting the treatment resistance of MPO-AAV patients with lung involvement, which might aid in individualizing treatment decisions.
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Affiliation(s)
- Juan Chen
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ting Meng
- Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jia Xu
- Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Joshua D. Ooi
- Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Centre for Inflammatory Diseases, Monash University, Clayton, VIC, Australia
| | | | - Wenguang Liu
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Fang Li
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xueqin Wu
- Department of Nephrology, The third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jian Sun
- Department of Nephrology, The third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Hao Zhang
- Department of Nephrology, The third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ya-Ou Zhou
- Department of Rheumatology and Immunology, Xiangya Hospital, Central South University, Changsha, China
| | - Hui Luo
- Department of Rheumatology and Immunology, Xiangya Hospital, Central South University, Changsha, China
| | - Xiangcheng Xiao
- Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yigang Pei
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Wenzheng Li
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yong Zhong
- Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Key Laboratory of Biological Nanotechnology of National Health Commission, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Shen D. Grand Challenges in Radiology. FRONTIERS IN RADIOLOGY 2021; 1:615138. [PMID: 37492165 PMCID: PMC10364983 DOI: 10.3389/fradi.2021.615138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 03/16/2021] [Indexed: 07/27/2023]
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Esterson YB, Esterson AY, Jankowska D, Goyal N. Incidental myocardial perfusion defect detected on ECG-gated CT aortogram. Clin Imaging 2019; 54:148-152. [PMID: 30654226 DOI: 10.1016/j.clinimag.2019.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 12/05/2018] [Accepted: 01/08/2019] [Indexed: 11/19/2022]
Abstract
We report the case of a 49-year-old man with a history of diabetes and hypertension who presented to the emergency room with intermittent chest pain radiating to the back for one day. An electrocardiogram-gated CT aortogram excluded the emergency department's primary consideration of aortic dissection, but incidentally revealed a myocardial perfusion defect and corresponding coronary artery stenosis. Cardiac catheterization performed the following day confirmed the CT findings and the patient underwent angioplasty and stent placement. We show that despite a different protocol than coronary CTA or myocardial perfusion CT, a gated CTA for dissection (CT aortogram) is capable of detecting resting perfusion abnormalities in patients presenting to the emergency room with chest pain.
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Affiliation(s)
- Yonah B Esterson
- Department of Radiology, Northwell Health System, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 300 Community Drive, Manhasset, NY 11030, USA.
| | - Aryeh Y Esterson
- Touro College of Osteopathic Medicine, 230 West 125th Street, New York, NY 10027, USA.
| | - Danuta Jankowska
- Department of Medicine, Lenox Hill Hospital, Northwell Health System, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 300 Community Drive, Manhasset, NY 11030, USA.
| | - Nikhil Goyal
- Department of Radiology, Northwell Health System, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 300 Community Drive, Manhasset, NY 11030, USA.
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Wu L, Hou Q, Lu Y, Bai J, Sun L, Huang Y, Zhang M, Zheng J. Feasibility of lung ultrasound to assess pulmonary overflow in congenital heart disease children. Pediatr Pulmonol 2018; 53:1525-1532. [PMID: 30251402 DOI: 10.1002/ppul.24169] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 09/05/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pulmonary overflow (PO) is one of the most common complications in congenital heart disease (CHD) children with an incidence of 48-60% approximately. This study explored the feasibility of using lung ultrasound (LUS) to assess pulmonary overcirculation in CHD children and compare the diagnostic performance of LUS and chest radiography (CXR) for the detection of pulmonary overcirculation. METHOD The upper anterior area, lower anterior area, upper lateral area, and lower posterior area, in each hemithorax were scanned in 59 children in the supine position. A-lines, B-lines in each scanned region were recorded, and the worst LUS abnormality in the video clip was considered to characterize the examined region. Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy of LUS and CXR were compared using computed tomography (CT) as a standard criterion. RESULTS PO was diagnosed in 53% (31/59), 63% (37/59), and 51% (30/59) children with CT, CXR, and LUS, respectively. The sensitivity, specificity, and diagnostic accuracy of PO were 96%, 94%, and 95% for LUS and 74%, 50%, and 63% for CXR. The percentage of mild, moderate, and severe PO diagnosed via LUS were 31% (18/59), 19% (11/59), and 2% (1/59), respectively. Furthermore, the PO incidence diagnosed by LUS in CHD children less than 1 year old were significantly higher than those beyond 1 year old. CONCLUSION LUS is a noninvasive and useful tool for the detection and assessment of PO in CHD children at the operating room, and is better than CXR in sensitivity and specificity, comparable to CT.
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Affiliation(s)
- Lei Wu
- Department of Anesthesiology, Shanghai Children's Medical Center Affiliated to School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qiaoru Hou
- Diagnostic imaging Center, Shanghai Children's Medical Center Affiliated to School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yingying Lu
- Department of Radiology, Renji Hospital Affiliated to School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jie Bai
- Department of Anesthesiology, Shanghai Children's Medical Center Affiliated to School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Liping Sun
- Department of Anesthesiology, Shanghai Children's Medical Center Affiliated to School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yue Huang
- Department of Anesthesiology, Shanghai Children's Medical Center Affiliated to School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Mazhong Zhang
- Department of Anesthesiology and Pediatric Clinical Pharmacology Laboratory, Shanghai Children's Medical Center Affiliated to School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jijian Zheng
- Department of Anesthesiology and Pediatric Clinical Pharmacology Laboratory, Shanghai Children's Medical Center Affiliated to School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Mei M, Nie J, Yang ZS, Sun HW, Wang H, Kang XM. Comparison of echocardiography and 64-slice spiral computed tomography in the diagnosis of congenital heart disease in children. J Cell Biochem 2018; 120:3969-3977. [PMID: 30321464 DOI: 10.1002/jcb.27682] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 08/27/2018] [Indexed: 02/02/2023]
Abstract
The diagnosis of congenital heart disease in children has been an issue in the medical community. Timely diagnosis and treatment can provide a greater guarantee for children's healthy growth. In recent years, there have been more and more studies on the diagnosis of congenital heart disease in children. This paper compares the advantages and disadvantages of echocardiography and 64-slice spiral computed tomography (CT) in the diagnosis of congenital heart disease in children. In clinical trials, we also tested 64 patients with spiral computed tomography (SCT) and transthoracic echocardiography (TTE) detection of patients and then confirmed the accuracy of the diagnosis by the surgical methods. The two methods of detection, the rate of missed diagnosis, and the rate of misdiagnosis were counted. Through the test results and pathological diagnosis results, the diagnostic accuracy of the two methods were all above 90%, each with its own advantages and disadvantages. The sensitivity of echocardiographic in detecting intracardiac structure abnormalities was relatively high, but when the diagnosis of extracardiac structural abnormalities less than 64-slice spiral CT method, misdiagnosis of TTE was mainly due to extracardiac vascular malformations. Therefore, it is recommended to combine the two methods to improve the diagnosis of congenital heart disease in children.
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Affiliation(s)
- Mei Mei
- The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China
| | - Jing Nie
- The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China
| | - Zhan Shuang Yang
- The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China
| | - Hua Wei Sun
- The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China
| | - He Wang
- The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China
| | - Xiao Ming Kang
- The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China
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6
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Reconstrucción cinemática en imagen cardiovascular. RADIOLOGIA 2018; 60:387-393. [DOI: 10.1016/j.rx.2018.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 02/20/2018] [Accepted: 03/29/2018] [Indexed: 11/20/2022]
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7
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Kinematic reconstruction in cardiovascular imaging. RADIOLOGIA 2018. [DOI: 10.1016/j.rxeng.2018.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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8
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Pierro A, Cilla S, Totaro A, Ienco V, Sacra C, De Filippo CM, Sallustio G. ECG-gated CT angiography of the thoracic aorta: the importance of evaluating the coronary arteries. Clin Radiol 2018; 73:983.e1-983.e6. [PMID: 30041811 DOI: 10.1016/j.crad.2018.06.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 06/20/2018] [Indexed: 12/26/2022]
Abstract
AIM To evaluate the feasibility of coronary artery disease (CAD) evaluation using electrocardiogram-gated computed tomography CT of the thoracic aorta. MATERIALS AND METHODS A total of 477 patients, who underwent CT angiography of the thoracic aorta, were included retrospectively. Dose-length products (DLP) were recorded. Two blinded readers graded image quality of the coronary arteries on a three-point scale. Coronary artery stenosis has only been reported if considered significant, i.e., ≥50%. The type of plaque responsible for the stenosis was considered. The normal distribution of the data was assessed using Shapiro-Wilk and Anderson-Darling tests. Results were expressed as means and standard deviations and percentages. Inter-reader agreements were analysed by calculating the intraclass correlation coefficient, and by using Cohen kappa statistics. RESULTS The mean DLP was 566±90.4 mGy∙cm, corresponding to an effective dose of 9.6±1.5 mSv. Five point three percent of asymptomatic patients were positive for CAD with stenosis ≥50%. All patients with coronary stenosis presented with a soft plaque. Two anomalous coronary origins were found. The inter-reader agreement was excellent in defining both the quality of the examination and the degree of coronary stenosis (k=0.85). CONCLUSION The opportunity to prove the presence of CAD in asymptomatic patients during a ECG-gated CT of the thoracic aorta can have an extremely important clinical impact, promoting the best therapeutic pathway for the patient. Therefore, coronary arteries should always be analysed carefully and reported in ECG-gated CT angiography of the thoracic aorta.
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Affiliation(s)
- A Pierro
- Radiology Department, Fondazione di Ricerca e Cura "Giovanni Paolo II", Università Cattolica del Sacro Cuore, Campobasso, Italy.
| | - S Cilla
- Medical Physics Unit, Fondazione di Ricerca e Cura "Giovanni Paolo II", Università Cattolica del Sacro Cuore, Campobasso, Italy
| | - A Totaro
- Division of Cardiology, Fondazione di Ricerca e Cura "Giovanni Paolo II", Università Cattolica del Sacro Cuore, Campobasso, Italy
| | - V Ienco
- Division of Cardiology, Fondazione di Ricerca e Cura "Giovanni Paolo II", Università Cattolica del Sacro Cuore, Campobasso, Italy
| | - C Sacra
- Division of Cardiology, Fondazione di Ricerca e Cura "Giovanni Paolo II", Università Cattolica del Sacro Cuore, Campobasso, Italy
| | - C M De Filippo
- Departement of Cardiovascular Surgery, Fondazione di Ricerca e Cura "Giovanni Paolo II", Università Cattolica del Sacro Cuore, Campobasso, Italy
| | - G Sallustio
- Radiology Department, Fondazione di Ricerca e Cura "Giovanni Paolo II", Università Cattolica del Sacro Cuore, Campobasso, Italy
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Cross-modality Accuracy of Dual-step, Prospectively Electrocardiography-triggered Dual-source Computed Tomorgaphy Compared With Same-day Echocardiography and Cardiac Magnetic Resonance Imaging in the Follow-up of Heart-transplant Patients. J Thorac Imaging 2018; 33:217-224. [DOI: 10.1097/rti.0000000000000323] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Pienn M, Burgard C, Payer C, Avian A, Urschler M, Stollberger R, Olschewski A, Olschewski H, Johnson T, Meinel FG, Bálint Z. Healthy Lung Vessel Morphology Derived From Thoracic Computed Tomography. Front Physiol 2018; 9:346. [PMID: 29755360 PMCID: PMC5932382 DOI: 10.3389/fphys.2018.00346] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 03/20/2018] [Indexed: 11/13/2022] Open
Abstract
Knowledge of the lung vessel morphology in healthy subjects is necessary to improve our understanding about the functional network of the lung and to recognize pathologic deviations beyond the normal inter-subject variation. Established values of normal lung morphology have been derived from necropsy material of only very few subjects. In order to determine morphologic readouts from a large number of healthy subjects, computed tomography pulmonary angiography (CTPA) datasets, negative for pulmonary embolism, and other thoracic pathologies, were analyzed using a fully-automatic, in-house developed artery/vein separation algorithm. The number, volume, and tortuosity of the vessels in a diameter range between 2 and 10 mm were determined. Visual inspection of all datasets was used to exclude subjects with poor image quality or inadequate artery/vein separation from the analysis. Validation of the algorithm was performed manually by a radiologist on randomly selected subjects. In 123 subjects (men/women: 55/68), aged 59 ± 17 years, the median overlap between visual inspection and fully-automatic segmentation was 94.6% (69.2–99.9%). The median number of vessel segments in the ranges of 8–10, 6–8, 4–6, and 2–4 mm diameter was 9, 34, 134, and 797, respectively. Number of vessel segments divided by the subject's lung volume was 206 vessels/L with arteries and veins contributing almost equally. In women this vessel density was about 15% higher than in men. Median arterial and venous volumes were 1.52 and 1.54% of the lung volume, respectively. Tortuosity was best described with the sum-of-angles metric and was 142.1 rad/m (138.3–144.5 rad/m). In conclusion, our fully-automatic artery/vein separation algorithm provided reliable measures of pulmonary arteries and veins with respect to age and gender. There was a large variation between subjects in all readouts. No relevant dependence on age, gender, or vessel type was observed. These data may provide reference values for morphometric analysis of lung vessels.
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Affiliation(s)
- Michael Pienn
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
| | - Caroline Burgard
- Clinic and Policlinic of Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany
| | - Christian Payer
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria.,Faculty of Computer Science and Biomedical Engineering, Institute of Computer Graphics and Vision, Graz University of Technology, Graz, Austria
| | - Alexander Avian
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Martin Urschler
- Faculty of Computer Science and Biomedical Engineering, Institute of Computer Graphics and Vision, Graz University of Technology, Graz, Austria.,Ludwig Boltzmann Institute for Clinical-Forensic Imaging, Graz, Austria
| | - Rudolf Stollberger
- Faculty of Computer Science and Biomedical Engineering, Institute of Medical Engineering, Graz University of Technology, Graz, Austria
| | - Andrea Olschewski
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
| | - Horst Olschewski
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria.,Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | | | - Felix G Meinel
- Department of Diagnostic and Interventional Radiology, Rostock University Medical Center, Rostock, Germany
| | - Zoltán Bálint
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria.,Faculty of Physics, Babeş-Bolyai University, Cluj-Napoca, Romania
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Stocker TJ, Deseive S, Chen M, Leipsic J, Hadamitzky M, Rubinshtein R, Grove EL, Fang XM, Lesser J, Maurovich-Horvat P, Marques H, Andreini D, Tabbalat R, Kang JW, Eckert J, Dickson P, Forsdahl SH, Lambrechtsen J, Cury RC, Hausleiter J. Rationale and design of the worldwide prospective multicenter registry on radiation dose estimates of cardiac CT angiography in daily practice in 2017 (PROTECTION VI). J Cardiovasc Comput Tomogr 2017; 12:81-85. [PMID: 29233632 DOI: 10.1016/j.jcct.2017.11.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 10/04/2017] [Accepted: 11/30/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND Cardiac computed tomography angiography (cardiac CTA) is an increasingly used versatile imaging method to evaluate coronary and cardiac morphology. Owing to improvements in technology, image quality has continuously improved over the last 10-20 years. At the same time, numerous non-randomized and randomized studies have been performed to reduce the associated radiation exposure. Currently, it is unclear if the advances in technology and knowledge about radiation reduction translated into reduced levels of cardiac CTA radiation dose in daily clinical practice as well as a wide utilization of dose-saving strategies. METHODS The PROTECTION VI study is a multicenter, prospective, worldwide registry designed to evaluate radiation dose exposure, utilization of dose-saving strategies and diagnostic image quality during cardiac CTA in current daily practice. Assessment of image quality will be addressed by the evaluation of diagnostic image quality at the local study site and the calculation of quantitative image quality parameters in an imaging core laboratory. Above 4000 patients will be enrolled from approximately 70 sites in Europe, North America, South America, Asia and Australia. The study will analyze median radiation dose levels, image quality, frequency of use and efficacy of algorithms for dose reduction, and patient and study-related predictors associated with radiation dose. CONCLUSIONS The PROTECTION VI study is designed to provide a reliable estimate of current radiation dose for cardiac CTA and to assess the potential for additional dose reductions.
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Affiliation(s)
- Thomas J Stocker
- Medizinische Klinik und Poliklinik I, Klinikum der Universität, Ludwig-Maximilians-Universität, Munich, Germany.
| | - Simon Deseive
- Medizinische Klinik und Poliklinik I, Klinikum der Universität, Ludwig-Maximilians-Universität, Munich, Germany
| | - Marcus Chen
- National Heart, Lung, and Blood Institute, Bethesda, United States
| | | | | | | | | | | | - John Lesser
- Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, United States
| | - Pál Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Budapest, Hungary
| | - Hugo Marques
- UNICA (Cardiovascular Imaging Unit), Hospital da Luz, Lisbon, Portugal
| | | | | | | | - Joachim Eckert
- Cardioangiologisches Centrum Bethanien (CCB), Frankfurt, Germany
| | | | | | | | | | - Jörg Hausleiter
- Medizinische Klinik und Poliklinik I, Klinikum der Universität, Ludwig-Maximilians-Universität, Munich, Germany.
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12
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Lee HY, Kim SM, Lee KS, Park SW, Chung MJ, Cho H, Jung JI, Jang HW, Jung SH, Goo J. Quantification of Aortic Valve Calcifications Detected During Lung Cancer-Screening CT Helps Stratify Subjects Necessitating Echocardiography for Aortic Stenosis Diagnosis. Medicine (Baltimore) 2016; 95:e3710. [PMID: 27175713 PMCID: PMC4902555 DOI: 10.1097/md.0000000000003710] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
No study has been published on aortic valve calcification (AVC) extent at lung cancer screening low-dose CT (LDCT) and its relationship with aortic stenosis (AS). The purpose of this study was to estimate the cutoff value of AVC on LDCT for detecting AS in asymptomatic Asian subjects. Six thousand three hundred thirty-eight subjects (mean age, 55.9 years ± 8.6) self-referred to health-promotion center underwent LDCT, coronary calcium scoring CT (CSCT), and echocardiography. AVC was quantified using Agatston methods on CT. AVC extent on LDCT was compared with that on CSCT, and AVC threshold for diagnosing AS was calculated. Clinical factors associated with AS and AVC were sought.AVC was observed in 403 subjects (64.9 years ± 8.7) on LDCT (6.4%), and AVC score measured from LDCT showed strong positive correlation with that from CSCT (r = 0.83, P < 0.0001). Of 403 subjects, 40 (10%) were identified to have AS on echocardiography. Cutoff value of AVC score for detecting AS was 138.37 with sensitivity of 90.0% and specificity 83.2%. On multivariate analysis, age (odds ratio [OR] = 1.10, 95% CI: 1.09-1.12) and hypertension (OR = 1.39, 95% CI: 1.10-1.76) were associated with the presence of AVC, whereas AVC extent at LDCT (OR = 104.32, 95% CI: 16.16-673.70) was the only significant clinical factor associated with AS; AVC extent on LDCT (OR = 104.32, 95% CI: 16.16-673.70) was the significant clinical factor associated with AS.The AVC extent on LDCT is significantly related to the presence of AS, and we recommend echocardiography for screening AS based on quantified AVC values on LDCT.
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Affiliation(s)
- Hee Young Lee
- From the Department of Radiology (HYL, SMK, KSL, MJC) and Division of Cardiology (SWP), Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine; Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center (HC); Department of Radiology (JIJ), Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea; Department of Medical Education (HWJ), Samsung Medical Center, Sungkyunkwan University School of Medicine; Biostatistics and Clinical Epidemiology Center (SHJ, JG), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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