Automated Coronary Artery Calcium and Quantitative Emphysema in Lung Cancer Screening; Association With Mortality, Lung Cancer Incidence, and Airflow Obstruction

Maurizio Balbi, Federica Sabia, Roberta E. Ledda, Gianluca Milanese, Margherita Ruggirello, Mario Silva, Alfonso V. Marchianò, Nicola Sverzellati, and Ugo Pastorino, MD
J Thorac Imaging
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Date Published

This study aimed to assess the use of automated coronary artery calcium (CAC) and quantitative emphysema (percentage of low attenuation areas [%LAA]) in predicting mortality and lung cancer incidence in lung cancer screening. Additionally, the study explored the correlations between %LAA, CAC, and forced expiratory value in 1 second (FEV1). The low-dose computed tomography (LDCT) images were analyzed using fully automated AI software, AVIEW, developed by Coreline Soft. A total of 4098 volunteers were enrolled, and the results showed that %LAA and CAC independently predicted 6-year all-cause, noncancer, and cardiovascular mortality. However, no significant association with lung cancer incidence was found after adjustments. Both biomarkers negatively correlated with FEV1, and %LAA demonstrated moderate discriminative ability in identifying airflow obstruction.


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