Multifactorial Analysis of Mortality in Screening Detected Lung Cancer

Abstract

We hypothesized that severity of coronary artery calcification (CAC), emphysema, muscle mass, and fat attenuation can help predict mortality in patients with lung cancer participating in the National Lung Screening Trial (NLST). Following regulatory approval from the Cancer Data Access System (CDAS), all patients diagnosed with lung cancer at the time of the screening study were identified. These subjects were classified into two groups: survivors and nonsurvivors at the conclusion of the NLST trial. These groups were matched based on their age, gender, body mass index (BMI), smoking history, lung cancer stage, and survival time. CAC, emphysema, muscle mass, and subcutaneous fat attenuation were quantified on baseline low-dose chest CT (LDCT) for all patients in both groups. Nonsurvivor group had significantly greater CAC, decreased muscle mass, and higher fat attenuation compared to the survivor group (p < 0.01). No significant difference in severity of emphysema was noted between the two groups (p > 0.1). We thus conclude that it is possible to create a quantitative prediction model for lung cancer mortality for subjects with lung cancer detected on screening low-dose CT (LDCT).

Knowledge-Based Analysis for Mortality Prediction From CT Images

“…This finding matches with the clinical literature that CAC is one of the major risk factors for mortality [4]. For survived subjects, the heatmaps suggest that KAMP-Net looks more at surrounding lung tissue and muscles as suggested by our previous work in [6]. For the heatmaps generated from image slices, survivors tend to have strong activation around the vertebral bone.…”

“…The CAC risk score is given by two radiologists, following a blinded and randomized manner. More detailed information about clinical measurements utilized in this work is available in the reference [6]. Those measurements contain high-level information and may not be readily grabbed by the CNNs.…”

“…In a different study, the Dutch-Belgian Randomized Lung Cancer Screening Trial (NELSON), it was found that CAC can predict all-cause mortality and cardiovascular events on lung cancer screening LDCT [5]. The work in [6] has also shown significant difference in CAC scores between the survivor and non-survivor groups, indicating that CAC influences the mortality risk of lung cancer patients. Moreover, other factors may also increase the mortality risk.…”

Management and Outcomes of Suspected Infectious and Inflammatory Lung Abnormalities Identified on Lung Cancer Screening CT

“…While the primary goal of lung cancer screening is to detect early, potentially curable lung cancer in high-risk individuals, incidental detection of a variety of asymptomatic pathologies is common (14)(15)(16)(17)(18)(19)(20)(21)(22). To our knowledge, this is the first study to address reporting patterns, recommendations, and outcomes in suspected acute infectious or inflammatory lung abnormalities detected during lung cancer screening.…”

Detection of Extrapulmonary Malignancy During Lung Cancer Screening: 5-Year Analysis at a Tertiary Hospital

“…Although the primary goal of lung cancer screening is the detection of early, potentially curable primary lung malignancies in high-risk individuals, incidental detection of various asymptomatic pathologies is common [5][6][7][8][9][10]. A number of studies, for example, have addressed the reporting of incidentally detected cardiovascular diseases and their impact on management [11,12].…”