Comparison of Framingham risk score and chest-CT identified coronary artery calcification in breast cancer patients to predict cardiovascular events

Radiologist Opinions Regarding Reporting Incidental Coronary And Cardiac Calcification On Thoracic CT

“…Extensive research has shown that coronary artery calcification is an effective marker of the presence of coronary artery disease and is associated with both cardiovascular and all-cause mortality in patients undergoing dedicated cardiac imaging or routine thoracic imaging [4,[12][13][14][15][16][17][18][19][20][21][27][28][29][30][31]. Nevertheless, our survey showed that coronary artery calcification was not reported by 11% of survey respondents.…”

“…Calcification in the coronary arteries, cardiac valves and thoracic aorta are frequent incidental findings (Figure 1) on routine non-gated thoracic computed tomography (CT) [1][2][3][4][5][6][7][8][9][10][11] and may indicate important underlying pathologies. However, little is known about the reporting practices of radiologists regarding these incidental findings.…”

Reliability of Coronary Artery Calcium Severity Assessment on Non-Electrocardiogram-Gated CT: A Meta-Analysis

“…The scan protocols of non-ECG-gated chest CT vary according to the scan indication, vendor, or institution. Therefore, it may be more important to properly categorize and report the CAC severity detected by non-ECG-gated CT than measure CAC scores because the prognostic value of CAC severity detected by non-ECG-gated CT for future mortality or major cardiovascular events has been demonstrated [ 6 7 8 9 ].…”

“…Although the primary indication for performing a chest CT is not to evaluate CAC, the importance of assessing CAC on non-ECG-gated chest CT examinations has been recognized. The presence and severity of CAC on chest CT are prognostic markers of future cardiovascular outcomes in various populations [ 6 7 8 9 ]. Therefore, the 2016 guidelines by the Society of Cardiovascular Computed Tomography (SCCT)/Society of Thoracic Radiology (STR) recommend that CAC should be evaluated and reported on all non-contrast chest CT scans of patients aged ≥ 40 years with an estimation of severity as none, mild, moderate, or severe [ 10 ].…”

Reporting incidental coronary, aortic valve and cardiac calcification on non-gated thoracic computed tomography, a consensus statement from the BSCI/BSCCT and BSTI

“…Recommendations for the assessment of cardiac calcification on routine thoracic CT Coronary artery calcification on non-gated thoracic CT CAC can be identified on non-gated thoracic CT with an excellent diagnostic accuracy compared to gated CT. 25,26 However, CAC is frequently not reported on non-gated thoracic CT, [27][28][29][30] and a recent survey demonstrated only 17% of noncardiothoracic radiologists in Canada were aware of the correlation between CAC scores on gated and non-gated thoracic CT. 31 The incidence of CAC on non-gated thoracic CT performed for non-cardiac indications varies from 26 to 93% depending on the population assessed. [28][29][30][32][33][34] It is associated with poorer prognosis in a variety of patient cohorts including patients with chronic obstructive pulmonary disease, pulmonary embolism, cancer and in unselected patients undergoing thoracic CT. 32,[35][36][37][38][39] In the National Lung Screening Trial, CAC was associated with an increased risk of coronary artery disease-related death, with a CAC score of 100-1000 AU associated with a fourfold increase, and CAC score of >1000 AU associated with a sevenfold increase compared to patients without CAC. 35 Reporting coronary calcification While conventional Agatston scoring remains the gold-standard assessment, it requires dedicated software and training.…”