CT Scanners, Lung Cancer Screening

AI Powers Two-for-One Screening

In our last issue, we described how effective coronary artery calcium scoring is in predicting future major adverse cardiovascular events. This week, we’re highlighting new research in AJR showing how – thanks to AI – CAC scoring can be performed on CT lung cancer screening exams, giving radiologists a two-for-one screening test.

Using data from one screening exam to also look for other diseases – known as opportunistic screening – has become a hot topic as a way to make screening even more clinically and economically effective. 

In the new study, South Korean researchers leveraged the country’s CT lung cancer screening program to also screen for CAC, a known marker for future cardiac events

  • They took two commercially available CAC scoring algorithms – Coreline Soft’s Aview CAC and Siemens Healthineers’ syngo Calcium Scoring – to analyze 1k low-dose CT chest images acquired from 2017-2023 as part of the national lung screening program. 

AI results were compared to radiologists’ interpretations of CAC presence and severity, finding … 

  • Substantial agreement between both the AI algorithms and the interpreting radiologists for CAC presence and severity (kappa=0.793 & 0.671)
  • The AI algorithms judged CAC to be more prevalent than radiologists (57-60% vs. 53%)
  • AI was more likely to judge CAC severity as mild (35-40% vs. 28%)
  • But less likely to grade it as severe (6.2%-7.3%  vs. 15%)
  • MACE incidence varied by CAC severity: no CAC (1.1-1.3%), mild (3-5%), moderate (2.9-7.9%), and severe (8.6-11%)

The researchers noted that, as with other studies, MACE incidence increased with CAC severity, underlining the importance of coronary calcium evaluation and supporting the use of CT lung screening for CAC detection. 

The Takeaway

Studies like this highlight the exciting role AI can play in making opportunistic screening a reality. With AI at their side, radiologists will be able to play an even more important role in catching disease early, when it can be treated most effectively.

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