Yoon Ki Cha MD, Presenter: Nothing to Disclose

Hee Young Lee MD, Abstract Co-Author: Nothing to Disclose

Kyung Soo Lee MD, PhD, Abstract Co-Author: Nothing to Disclose

So Hyeon Bak MD, Abstract Co-Author: Nothing to Disclose

Hyoun Cho MD, Abstract Co-Author: Nothing to Disclose

Sung Mok Kim MD, Abstract Co-Author: Nothing to Disclose

To correlate the presence and extent of coronary artery calcium(CAC) with those of aortic valve calcium(AVC), and to compare the presence and extent of CAC and AVC at low-dose ungated MDCT for lung cancer screening (LDCT) with measures at ECG-synchronized MDCT for coronary calcium score (CCS).

From 2008 to 2009, 454 patients (68.1 ± 7.9 years, 420 male) underwent screening same-day LDCT (5.0-mm-section thickness) followed by CCS CT in asymptomatic patients for chest disease. In 278 patients with a CCS CT positive for AVC, CAC and AVC were quantified using Agatston scores. The severity of AS was evaluated with Doppler echocardiography using a peak velocity and a pressure gradient. The severity of AS was compared with AVC measured at LDCT.

The median CAC score was higher in individuals with combined AVC+CAC than in those with CAC only. 14.7 % of individuals with AVC had CAC score >400 (extensive plaque burden). There was weak correlation or some linear tendency between CAC and AVC score (r = 0.20, p = 0.001) at LDCT. In patients with AS, Doppler echocardiography demonstrated a mean peak velocity of 2.74 ± 1.27 m/s and a mean pressure gradient of 17.45 ± 17.37 mmHg. The median AVC score at LDCT was 947.9 (interquartile range, 163.0-2924.3). The AVC score at LDCT positively correlated with the peak velocity and pressure gradient (r =0.71 for both, p = 0.009 and p = 0.005, respectively) of the AV. All patients with severe AS had a calcium score of >3300. CAC and AVC scores from LDCT showed strong positive correlation with those from the CCS (r = 0.87, limits of agreement -533.1 to 260.58 for CAC and r = 0.88, limits of agreement -397.07 to 457.17 for AVC).

Weak correlation or some linear tendency is seen in CAC and AVC scores at LDCT and a close linear relation between echocardiographic parameters of severity of AS and AVC scores at LDCT is identified. Moreover, using non-gated MDCT for lung cancer screening, we can detect CAC and AVC and obtain results comparable to those obtained with dedicated ECG-gated calcium-scoring CT.

LDCT for lung cancer screening, performed in high-risk smokers for lung cancer having also a potential for coronary artery disease with such smoking, should be evaluated for the presence and extent of coronary artery and aortic valve calcifications, because the LDCT technique appears to be feasible in detecting and quantifying the calcifications.

Cha, Y, Lee, H, Lee, K, Bak, S, Cho, H, Kim, S, Coronary Artery and Aortic Valve Calcifications Seen at Lung Cancer Screening Low-Dose CT: Clinical Meaning and Correlation with Echocardiographic Findings.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14007114.html