Prognostic value of coronary artery calcium scoring in patients with non-small cell lung cancer using initial staging computed tomography

Aryan Zahergivar, Internal Medicine Department, District of Columbia, George Washington University, District of Columbia, Washington, USA.
Mahshid Golagha, Urology Oncology Branch, National Cancer Institutes, National Institutes of Health, Bethesda, MD, USA.
Greg Stoddard, Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA.
Parker Sage Anderson, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA.
Lacey Woods, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA.
Anna Newman, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA.
Malorie R. Carter, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA.
Libo Wang, Department of Internal Medicine, Division of Cardiology, University of Utah, Salt Lake City, Utah, USA.
Mark Ibrahim, Department of Internal Medicine, Division of Cardiology, University of Utah, Salt Lake City, Utah, USA.
Jordan Chamberlin, Department of Radiology, Medical University of South Carolina, Charleston, South Carolina, USA.
William F. Auffermann, Department of Radiology, Cardiothoracic Imaging, University of Utah, 30 N 1900 E #1A71, Salt Lake City, Utah, 84132, USA.
Ismail Kabakus, Department of Radiology, Medical University of South Carolina, Charleston, South Carolina, USA.
Jeremy R. Burt, Department of Radiology, Cardiothoracic Imaging, University of Utah, 30 N 1900 E #1A71, Salt Lake City, Utah, 84132, USA. radhopkins@hsc.utah.edu.

Document Type

Journal Article

Publication Date

12-27-2024

Journal

BMC medical imaging

Volume

24

Issue

1

DOI

10.1186/s12880-024-01544-6

Keywords

Coronary artery calcium scoring; FDG-PET/CT; Non-small cell lung cancer

Abstract

BACKGROUND: Lung cancer is a leading cause of cancer-related mortality worldwide, with non-small cell lung cancer (NSCLC) comprising 85% of cases. Due to the lack of early clinical signs, metastasis often occurs before diagnosis, impacting treatment and prognosis. Cardiovascular disease (CVD) is a common comorbidity in lung cancer patients, with shared risk factors exacerbating outcomes. METHODS: This study investigates the association between coronary artery calcium (CAC) scores, major adverse cardiovascular events (MACE), and survival outcomes in NSCLC patients, utilizing positron emission tomography-computed tomography (PET-CT) for CAC scoring. A retrospective cohort study of 154 NSCLC patients (mean age 66.3 years, 52% women) at the University of Utah (2005-2022) was conducted. Baseline PET-CT or CT imaging was used to quantify CAC scores, categorized into five risk levels. Cox proportional hazards and logistic regression analyses assessed the impact of CAC scores on survival and cardiovascular events, adjusting for confounders such as age, gender, and smoking status. RESULTS: Higher CAC scores were significantly associated with increased MACE, acute myocardial infarction (MI), and poorer overall survival. The severe risk CAC score group had significantly lower survival (p = 0.022). Logistic regression revealed a strong association between higher CAC scores and MI incidence (moderate: OR = 13.8, severe: OR = 21.2) and MACE (severe: OR = 10.2). Smoking history was a significant predictor of overall survival (p = 0.006). CONCLUSION: CAC scoring via PET-CT provides valuable prognostic insights in NSCLC patients, highlighting the need for integrated cardiovascular risk management in this population. Further research and advanced technologies like machine learning could enhance CAC scoring application in clinical practice. TRIAL REGISTRATION: Retrospectively registered.

Department

School of Medicine and Health Sciences Resident Works

Link to Full Text

Share

COinS