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Novogrodsky E, Haramati LB, Villasana-Gomez GM, Goldman J, Rosenfeld C, Rosenblum JK, Sayre JW, Hoyt AC, Goldin JG, Milch HS. Lung Cancer Screening Among Mammography Patients: Knowledge, Eligibility, Participation, and Interest. J Am Board Fam Med 2023; 36:557-564. [PMID: 37321658 DOI: 10.3122/jabfm.2022.220423r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/05/2023] [Accepted: 03/13/2023] [Indexed: 06/17/2023] Open
Abstract
OBJECTIVE To determine lung cancer screening eligibility, knowledge, and interest and to quantify the effect of the expanded 2021 lung cancer screening eligibility criteria among women presenting for screening mammography, a group with demonstrable interest in cancer screening. METHODS A single-page survey was distributed to patients presenting for screening mammography, from January-March 2020 and June 2020-January 2021, at 2 academic medical centers on the East and West Coasts. The population served by the East Coast institution has greater poverty, greater ethnic/racial diversity, and lower education levels. Survey questions included age, smoking history, lung cancer screening knowledge, participation, and interest. Lung cancer screening eligibility was determined for both 2013 and 2021 USPSTF guidelines. Descriptive statistics were calculated, and data were compared between groups using the Chi-square test, Mann-Whitney nonparametric test, and the 2-sample t test. RESULTS 5512 surveys were completed; 33% (1824) of women reported a history of smoking-30% (1656) former smokers and 3% (156) current smokers. Among women with a smoking history, 7% (127/1824) were eligible for lung cancer screening using 2013% and 11% (207/1824) using the 2021 USPSTF criteria. Interest in lung cancer screening was high (73%; 151/207) among eligible women using 2021 USPSTF criteria, but only 42% (87/207) had heard of lung cancer screening and only 28% (57/207) had received prior LDCT screening. CONCLUSION Eligible screening mammography patients reported high levels of interest in lung cancer screening but low levels of knowledge and participation. Linking mammography and LDCT appointments may improve lung cancer screening participation.
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Affiliation(s)
- Eitan Novogrodsky
- From the Department of Radiology, Montefiore Medical Center, Bronx, New York (EN, JG,); Albert Einstein College of Medicine, Bronx, New York (EN, LBH, GMV, JG, CR, JKR); Departments of Radiology and Medicine, Montefiore Medical Center, Bronx, New York (LBH); Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut (LBH), Department of Radiology, Jacobi Medical Center, Bronx, New York (GMV, CR, JKR); Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California (JWS, ACH, JGG, HSM).
| | - Linda B Haramati
- From the Department of Radiology, Montefiore Medical Center, Bronx, New York (EN, JG,); Albert Einstein College of Medicine, Bronx, New York (EN, LBH, GMV, JG, CR, JKR); Departments of Radiology and Medicine, Montefiore Medical Center, Bronx, New York (LBH); Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut (LBH), Department of Radiology, Jacobi Medical Center, Bronx, New York (GMV, CR, JKR); Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California (JWS, ACH, JGG, HSM)
| | - Geraldine M Villasana-Gomez
- From the Department of Radiology, Montefiore Medical Center, Bronx, New York (EN, JG,); Albert Einstein College of Medicine, Bronx, New York (EN, LBH, GMV, JG, CR, JKR); Departments of Radiology and Medicine, Montefiore Medical Center, Bronx, New York (LBH); Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut (LBH), Department of Radiology, Jacobi Medical Center, Bronx, New York (GMV, CR, JKR); Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California (JWS, ACH, JGG, HSM)
| | - Jessica Goldman
- From the Department of Radiology, Montefiore Medical Center, Bronx, New York (EN, JG,); Albert Einstein College of Medicine, Bronx, New York (EN, LBH, GMV, JG, CR, JKR); Departments of Radiology and Medicine, Montefiore Medical Center, Bronx, New York (LBH); Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut (LBH), Department of Radiology, Jacobi Medical Center, Bronx, New York (GMV, CR, JKR); Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California (JWS, ACH, JGG, HSM)
| | - Cyril Rosenfeld
- From the Department of Radiology, Montefiore Medical Center, Bronx, New York (EN, JG,); Albert Einstein College of Medicine, Bronx, New York (EN, LBH, GMV, JG, CR, JKR); Departments of Radiology and Medicine, Montefiore Medical Center, Bronx, New York (LBH); Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut (LBH), Department of Radiology, Jacobi Medical Center, Bronx, New York (GMV, CR, JKR); Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California (JWS, ACH, JGG, HSM)
| | - Jessica K Rosenblum
- From the Department of Radiology, Montefiore Medical Center, Bronx, New York (EN, JG,); Albert Einstein College of Medicine, Bronx, New York (EN, LBH, GMV, JG, CR, JKR); Departments of Radiology and Medicine, Montefiore Medical Center, Bronx, New York (LBH); Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut (LBH), Department of Radiology, Jacobi Medical Center, Bronx, New York (GMV, CR, JKR); Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California (JWS, ACH, JGG, HSM)
| | - James W Sayre
- From the Department of Radiology, Montefiore Medical Center, Bronx, New York (EN, JG,); Albert Einstein College of Medicine, Bronx, New York (EN, LBH, GMV, JG, CR, JKR); Departments of Radiology and Medicine, Montefiore Medical Center, Bronx, New York (LBH); Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut (LBH), Department of Radiology, Jacobi Medical Center, Bronx, New York (GMV, CR, JKR); Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California (JWS, ACH, JGG, HSM)
| | - Anne C Hoyt
- From the Department of Radiology, Montefiore Medical Center, Bronx, New York (EN, JG,); Albert Einstein College of Medicine, Bronx, New York (EN, LBH, GMV, JG, CR, JKR); Departments of Radiology and Medicine, Montefiore Medical Center, Bronx, New York (LBH); Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut (LBH), Department of Radiology, Jacobi Medical Center, Bronx, New York (GMV, CR, JKR); Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California (JWS, ACH, JGG, HSM)
| | - Jonathan G Goldin
- From the Department of Radiology, Montefiore Medical Center, Bronx, New York (EN, JG,); Albert Einstein College of Medicine, Bronx, New York (EN, LBH, GMV, JG, CR, JKR); Departments of Radiology and Medicine, Montefiore Medical Center, Bronx, New York (LBH); Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut (LBH), Department of Radiology, Jacobi Medical Center, Bronx, New York (GMV, CR, JKR); Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California (JWS, ACH, JGG, HSM)
| | - Hannah S Milch
- From the Department of Radiology, Montefiore Medical Center, Bronx, New York (EN, JG,); Albert Einstein College of Medicine, Bronx, New York (EN, LBH, GMV, JG, CR, JKR); Departments of Radiology and Medicine, Montefiore Medical Center, Bronx, New York (LBH); Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut (LBH), Department of Radiology, Jacobi Medical Center, Bronx, New York (GMV, CR, JKR); Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California (JWS, ACH, JGG, HSM)
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Hernandez-Meza G, Vietti Violi N, Said D, Novogrodsky E, Villavisanis D, Maron SZ, Frere J, Schiano TD, Friedman S, Boffetta P, Branch A, Taouli B. MRI is the most commonly used imaging modality for HCC screening at a tertiary care transplant center. Abdom Radiol (NY) 2021; 46:5142-5151. [PMID: 34283266 DOI: 10.1007/s00261-021-03212-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 05/25/2021] [Accepted: 07/08/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE In this study, we describe the patterns of hepatocellular carcinoma (HCC) screening with imaging and factors associated with imaging modality selection in a tertiary care transplant center. METHODS This was a retrospective study where all adult patients with cirrhosis and/or chronic hepatitis B virus infection referred for HCC screening with ultrasound (US), CT or MRI were identified during 2017. The association between imaging methods, demographic/clinical data were analyzed by uni- and multivariate analysis. RESULTS A total of 1437 patients were included (median age 61y, 59% male, median BMI 27.5 kg/m2, median AFP 3.4 ng/mL, 37% with HCV and 87% with cirrhosis). Index screening imaging method utilization included MRI (51%), US (33%) and CT (16%). Use of US as the index imaging modality for screening was significantly associated with race/ethnicity [Odds Ratio (OR) 1.71-2.01, all p < 0.05] in multivariate analysis. Presence of cirrhosis (OR 0.29, p < 0.001) and referral by a hepatologist (OR 0.23, p < 0.001) were associated with screening with MRI in the multivariate analysis; while gender, age, BMI, etiology and income at ZIP code of residence were not significantly associated with imaging modality selection. HCC was observed in 62 patients (prevalence 4.3%). Rate of HCC detection was significantly higher with MRI vs US (5.9% vs. 1.5%, p = 0.001). CONCLUSION MRI was the most frequently used modality (> 50%) for HCC screening in our tertiary care center, in contrast with the current practice guidelines. Race/ethnicity, cirrhosis and referral by a hepatologist were associated with the imaging method used for HCC screening.
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Affiliation(s)
- Gabriela Hernandez-Meza
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai (ISMMS), 1470 Madison Avenue, New York, NY, 10029, USA
- BioMedical Engineering and Imaging Institute, ISMMS, 1470 Madison Avenue, New York, NY, 10029, USA
| | - Naik Vietti Violi
- BioMedical Engineering and Imaging Institute, ISMMS, 1470 Madison Avenue, New York, NY, 10029, USA
- Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Daniela Said
- BioMedical Engineering and Imaging Institute, ISMMS, 1470 Madison Avenue, New York, NY, 10029, USA
- Department of Radiology, Universidad de los Andes, Santiago, Chile
| | - Eitan Novogrodsky
- Department of Radiology, Albert Einstein College of Medicine, New York, NY, USA
| | - Dillan Villavisanis
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai (ISMMS), 1470 Madison Avenue, New York, NY, 10029, USA
- BioMedical Engineering and Imaging Institute, ISMMS, 1470 Madison Avenue, New York, NY, 10029, USA
| | - Samuel Z Maron
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai (ISMMS), 1470 Madison Avenue, New York, NY, 10029, USA
- BioMedical Engineering and Imaging Institute, ISMMS, 1470 Madison Avenue, New York, NY, 10029, USA
| | - Justin Frere
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai (ISMMS), 1470 Madison Avenue, New York, NY, 10029, USA
- BioMedical Engineering and Imaging Institute, ISMMS, 1470 Madison Avenue, New York, NY, 10029, USA
| | - Thomas D Schiano
- Recanati/Miller Transplantation Institute, ISMMS, New York, NY, USA
| | | | - Paolo Boffetta
- Tisch Cancer Institute, ISMMS, New York, NY, USA
- Department of Family, Population & Preventive Medicine, Renaissance School of Medicine, Stony Brook, NY, USA
| | - Andrea Branch
- Division of Liver Diseases, ISMMS, New York, NY, USA
| | - Bachir Taouli
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai (ISMMS), 1470 Madison Avenue, New York, NY, 10029, USA.
- BioMedical Engineering and Imaging Institute, ISMMS, 1470 Madison Avenue, New York, NY, 10029, USA.
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Slipczuk L, Castagna F, Schonberger A, Novogrodsky E, Dey D, Jorde UP, Levsky JM, Di Biase L, Garcia MJ. Incidence of new-onset atrial fibrillation in COVID-19 is associated with increased epicardial adipose tissue. J Interv Card Electrophysiol 2021; 64:383-391. [PMID: 34231098 PMCID: PMC8260236 DOI: 10.1007/s10840-021-01029-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/24/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE Coronary artery calcium (CAC) and epicardial adipose tissue (EAT) can predict AF in the general population. We aimed to determine if CAC and EAT measured by computed tomographic (CT) scanning can predict new-onset AF in patients admitted with COVID-19 disease. METHODS We performed a retrospective, post hoc analysis of all patients admitted to Montefiore Medical Center with a confirmed COVID-19 diagnosis from March 1st to June 23rd, 2020, who had a non-contrast CT of the chest within 5 years prior to admission. We determined ordinal CAC scores and quantified the EAT volume and examined their relationship with inpatient mortality. RESULTS A total of 379 patients were analyzed. There were 16 events of new-onset AF (4.22%). Patients who developed AF during the index admission were more likely to be male (75 vs 47%, p < 0.001) and had higher EAT (129.5 [76.3-197.3] vs 91.0 [60.0-129.0] ml, p = 0.049). There were no differences on age (68 [56-71] vs 68 [58-76] years; p = 0.712), BMI (28.5 [25.3-30.8] vs 26.9 [23.1-31.8] kg/m2; p = 0.283), ordinal CAC score (3 [1-6] vs 2 [0-4]; p = 0.482), or prevalence of diabetes (56.3 vs 60.1%; p = 0.761), hypertension (75.0 vs 87.3%, p = 0.153), or coronary artery disease (50.0 vs 39.4%, p = 0.396). Patients with new-onset AF had worse clinical outcomes (death/intubation/vasopressors) (87.5 vs 44.1%; p = 0.001). CONCLUSION Increased EAT measured by non-contrast chest CT identifies patients hospitalized with COVID-19 at higher risk of developing new-onset AF. Patients with new-onset AF have worse clinical outcomes.
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Affiliation(s)
- Leandro Slipczuk
- Cardiology Division, Montefiore Medical Center, 111 E 210th, Bronx, NY, 10467, USA. .,Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Francesco Castagna
- Cardiology Division, Montefiore Medical Center, 111 E 210th, Bronx, NY, 10467, USA
| | | | | | - Damini Dey
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Ulrich P Jorde
- Cardiology Division, Montefiore Medical Center, 111 E 210th, Bronx, NY, 10467, USA.,Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jeffrey M Levsky
- Albert Einstein College of Medicine, Bronx, NY, USA.,Radiology Division, Montefiore Medical Center, Bronx, NY, USA
| | - Luigi Di Biase
- Cardiology Division, Montefiore Medical Center, 111 E 210th, Bronx, NY, 10467, USA.,Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mario J Garcia
- Cardiology Division, Montefiore Medical Center, 111 E 210th, Bronx, NY, 10467, USA.,Albert Einstein College of Medicine, Bronx, NY, USA.,Radiology Division, Montefiore Medical Center, Bronx, NY, USA
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Slipczuk L, Castagna F, Schonberger A, Novogrodsky E, Sekerak R, Dey D, Jorde UP, Levsky JM, Garcia MJ. Coronary artery calcification and epicardial adipose tissue as independent predictors of mortality in COVID-19. Int J Cardiovasc Imaging 2021; 37:3093-3100. [PMID: 33978937 PMCID: PMC8113796 DOI: 10.1007/s10554-021-02276-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/03/2021] [Indexed: 12/17/2022]
Abstract
Recent epidemiological studies have demonstrated that common cardiovascular risk factors are strongly associated with adverse outcomes in COVID-19. Coronary artery calcium (CAC) and epicardial fat (EAT) have shown to outperform traditional risk factors in predicting cardiovascular events in the general population. We aim to determine if CAC and EAT determined by Computed Tomographic (CT) scanning can predict all-cause mortality in patients admitted with COVID-19 disease. We performed a retrospective, post-hoc analysis of all patients admitted to Montefiore Medical Center with a confirmed COVID-19 diagnosis from March 1st, 2020 to May 2nd, 2020 who had a non-contrast CT of the chest within 5 years prior to admission. We determined ordinal CAC scores and quantified the epicardial (EAT) and thoracic (TAT) fat volume and examined their relationship with inpatient mortality. A total of 493 patients were analyzed. There were 197 deaths (39.95%). Patients who died during the index admission had higher age (72, [64–80] vs 68, [57–76]; p < 0.001), CAC score (3, [0–6] vs 1, [0–4]; p < 0.001) and EAT (107, [70–152] vs 94, [64–129]; p = 0.023). On a competing risk analysis regression model, CAC ≥ 4 and EAT ≥ median (98 ml) were independent predictors of mortality with increased mortality of 63% (p = 0.003) and 43% (p = 0.032), respectively. As a composite, the group with a combination of CAC ≥ 4 and EAT ≥ 98 ml had the highest mortality. CAC and EAT measured from chest CT are strong independent predictors of inpatient mortality from COVID-19 in this high-risk cohort.
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Affiliation(s)
- Leandro Slipczuk
- Cardiology Division, Montefiore Medical Center, 111 E 210th, Bronx, NY, 10467, USA. .,Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Francesco Castagna
- Cardiology Division, Montefiore Medical Center, 111 E 210th, Bronx, NY, 10467, USA
| | | | | | | | - Damini Dey
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Ulrich P Jorde
- Cardiology Division, Montefiore Medical Center, 111 E 210th, Bronx, NY, 10467, USA.,Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jeffrey M Levsky
- Albert Einstein College of Medicine, Bronx, NY, USA.,Radiology Division, Montefiore Medical Center, Bronx, NY, USA
| | - Mario J Garcia
- Cardiology Division, Montefiore Medical Center, 111 E 210th, Bronx, NY, 10467, USA.,Albert Einstein College of Medicine, Bronx, NY, USA.,Radiology Division, Montefiore Medical Center, Bronx, NY, USA
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