Age and sex based reference values for incidental coronary artery and thoracic aorta calcifications on routine clinical chest CT: a powerful tool to appreciate available imaging findings.

Objective: To establish age and gender specific reference values for incidental coronary artery and thoracic aorta calcification scores on routine diagnostic CT scans. These reference values can aid in structured reporting and interpretation of readily available imaging data by chest CT readers in routine practice.

Methods: A random sample of 1572 (57% male, median age 61 years) was taken from a study population of 12,063 subjects who underwent diagnostic chest CT for non-cardiovascular indications between January 2002 and December 2005.

Incidental imaging findings from routine chest CT used to identify subjects at high risk of future cardiovascular events.

Purpose: To investigate the contribution of incidental findings at chest computed tomography (CT) in the detection of subjects at high risk for cardiovascular disease (CVD) by deriving and validating a CT-based prediction rule.

Materials And Methods: This retrospective study was approved by the ethical review board of the primary participating facility, and informed consent was waived. The derivation cohort comprised 10 410 patients who underwent diagnostic chest CT for noncardiovascular indications.

Lung cancer screening CT-based prediction of cardiovascular events.

Objectives: The aim of this study was to derivate and validate a prediction model for cardiovascular events based on quantification of coronary and aortic calcium volume in lung cancer screening chest computed tomography (CT).

Background: CT-based lung cancer screening in heavy smokers is a very timely topic. Given that the heavily smoking screening population is also at risk for cardiovascular disease, CT-based screening may provide the opportunity to additionally identify participants at high cardiovascular risk.

Diagnosis of chronic obstructive pulmonary disease in lung cancer screening Computed Tomography scans: independent contribution of emphysema, air trapping and bronchial wall thickening.

Background: Beyond lung cancer, screening CT contains additional information on other smoking related diseases (e.g. chronic obstructive pulmonary disease, COPD).

Development and validation of a prediction rule for recurrent vascular events based on a cohort study of patients with arterial disease: the SMART risk score.

Objectives: To enable risk stratification of patients with various types of arterial disease by the development and validation of models for prediction of recurrent vascular event risk based on vascular risk factors, imaging or both.

Design: Prospective cohort study.

Setting: University Medical Centre.

A simple adaptation method improved the interpretability of prediction models for composite end points.

Objective: The pros and cons of composite end points in prognostic research are discussed, and an adaptation method, designed to accurately adjust absolute risks for a composite end point to risks for the individual component outcomes, is presented.

Study Design And Setting: An example prediction model for recurrent cardiovascular events (composite end point) was used to evaluate the performance regarding the individual component outcomes (cardiovascular death, myocardial infarction, and stroke) before and after the adaptation method.

Results: Discrimination for the individual component outcomes (concordance index for myocardial infarction, 0.

Unrequested findings on cardiac computed tomography: looking beyond the heart.

Objectives: To determine the prevalence of clinically relevant unrequested extra-cardiac imaging findings on cardiac Computed Tomography (CT) and explanatory factors thereof.

Methods: A systematic review of studies drawn from online electronic databases followed by meta-analysis with meta-regression was performed. The prevalence of clinically relevant unrequested findings and potentially explanatory variables were extracted (proportion of smokers, mean age of patients, use of full FOV, proportion of men, years since publication).

Coronary artery calcium can predict all-cause mortality and cardiovascular events on low-dose CT screening for lung cancer.

Objective: Performing coronary artery calcium (CAC) screening as part of low-dose CT lung cancer screening has been proposed as an efficient strategy to detect people with high cardiovascular risk and improve outcomes of primary prevention. This study aims to investigate whether CAC measured on low-dose CT in a population of former and current heavy smokers is an independent predictor of all-cause mortality and cardiac events.

Subjects And Methods: We used a case-cohort study and included 958 subjects 50 years old or older within the screen group of a randomized controlled lung cancer screening trial.

The prognostic value of vascular diameter measurements on routine chest computed tomography in patients not referred for cardiovascular indications.

Objectives: The aim of the study was to investigate whether diameter measurements of the thoracic aorta and the heart can be used as prognostic markers for future cardiovascular disease.

Methods: Following a case-cohort design, a total of 10,410 patients undergoing chest computed tomography were followed up for a mean period of 17 months. The ones with a cardiovascular indication were excluded.

Prediction of cardiovascular events by using non-vascular findings on routine chest CT.

Background: Routine computed tomography (CT) examinations contain an abundance of findings unrelated to the diagnostic question. Those with prognostic significance may contribute to early detection and treatment of disease, irrelevant findings can be ignored. We aimed to assess the association between unrequested chest CT findings in lungs, mediastinum and pleura and future cardiovascular events.

Unrequested information from routine diagnostic chest CT predicts future cardiovascular events.

Objectives: An increase in the number of CT investigations will likely result in a an increase in unrequested information. Clinical relevance of these findings is unknown. This is the first follow-up study to investigate the prognostic relevance of subclinical coronary (CAC) and aortic calcification (TAC) as contained in routine diagnostic chest CT in a clinical care population.

The association of incidentally detected heart valve calcification with future cardiovascular events.

Objectives: This study aims to investigate the prognostic value of incidental aortic valve calcification (AVC), mitral valve calcification (MVC) and mitral annular calcification (MAC) for cardiovascular events and non-rheumatic valve disease in particular on routine diagnostic chest CT.

Methods: The study followed a case-cohort design. 10410 patients undergoing chest CT were followed for a median period of 17 months.

Cardiovascular disease: prediction with ancillary aortic findings on chest CT scans in routine practice.

Purpose: To predict cardiovascular disease (CVD) in a clinical care population by using prevalent subclinical ancillary aortic findings detected on chest computed tomographic (CT) images.

Materials And Methods: The study was approved by the medical ethics committee of the primary participating facility and the institutional review boards of all other participating centers. From a total of 6975 patients who underwent diagnostic contrast material-enhanced chest CT for noncardiovascular indications, a representative sample population of 817 patients plus 347 patients who experienced a cardiovascular event during a mean follow-up period of 17 months were assigned visual scores for ancillary aortic abnormalities--on a scale of 0-8 for calcifications, a scale of 0-4 for plaques, a scale of 0-4 for irregularities, and a scale of 0-1 for elongation.

Coronary artery calcification scoring in low-dose ungated CT screening for lung cancer: interscan agreement.

Objective: In previous studies detection of coronary artery calcification (CAC) with low-dose ungated MDCT performed for lung cancer screening has been compared with detection with cardiac CT. We evaluated the interscan agreement of CAC scores from two consecutive low-dose ungated MDCT examinations.

Subjects And Methods: The subjects were 584 participants in the screening segment of a lung cancer screening trial who underwent two low-dose ungated MDCT examinations within 4 months (mean, 3.

Comparing coronary artery calcium and thoracic aorta calcium for prediction of all-cause mortality and cardiovascular events on low-dose non-gated computed tomography in a high-risk population of heavy smokers.

Background: Coronary artery calcium (CAC) and thoracic aorta calcium (TAC) can be detected simultaneously on low-dose, non-gated computed tomography (CT) scans. CAC has been shown to predict cardiovascular (CVD) and coronary (CHD) events. A comparable association between TAC and CVD events has yet to be established, but TAC could be a more reproducible alternative to CAC in low-dose, non-gated CT.