image: (A) Axial CT image shows coronary artery calcium (red square). (B) Axial CT image shows pulmonary artery and ascending aorta diameter at level of main pulmonary artery (red arrows). Coronal CT images (C) without and (D) with segmentation label map for lung densitometry to assess emphysema; label map shows lung parenchyma in blue and major airways in red. Axial CT images (E) without and (F) segmentation label map at level of fifth thoracic vertebral body, (G) without and (H) with segmentation label map at level of eighth thoracic vertebral body, and (I) without and (J) with segmentation label map at level of tenth vertebral body, for body composition analysis. Skeletal muscle in red; adipose tissue in green. Axial CT images (K) without and (L) with bone mineral density measurement, depicted by yellow ROI at first lumbar vertebral body. view more
Credit: American Roentgen Ray Society (ARRS), American Journal of Roentgenology (AJR)
Leesburg, VA, April 13, 2022—According to ARRS’ American Journal of Roentgenology (AJR), noncancerous imaging markers on chest CT performed before stereotactic body radiation therapy (SBRT) improve survival prediction, compared with clinical features alone.
“In patients undergoing SBRT for stage I lung cancer,” explained corresponding author and 2019 ARRS Scholar Florian J. Fintelmann, “higher coronary artery calcium (CAC) score, higher pulmonary artery (PA)-to-aorta ratio, and lower thoracic skeletal muscle index independently predicted worse overall survival.”
Fintelmann and team’s retrospective study included 282 patients (168 female, 114 male; median age, 75 years) with stage I lung cancer treated with SBRT between January 2009 and June 2017. To quantify CAC score and PA-to-aorta ratio, as well as emphysema and body composition, pretreatment chest CT was used. Associations of clinical and imaging features with overall were quantified using a multivariable Cox proportional hazards (PH) model.
For stage I lung cancer patients treated with SBRT, CAC score, PA-to-aorta ratio, and skeletal muscle index showed significant independent associations with overall survival. (p<.05). The model including clinical and imaging features demonstrated better discriminatory ability for 5-year overall survival than the model including clinical features alone (AUC 0.75 vs. 0.61, p<.01).
“The PA-to-aorta ratio, which is readily quantifiable with electronic calipers during routine image review, was the most important predictor of overall survival,” the authors of this AJR article concluded.
An electronic supplement to this AJR article is available here.
North America’s first radiological society, the American Roentgen Ray Society (ARRS) remains dedicated to the advancement of medicine through the profession of medical imaging and its allied sciences. An international forum for progress in radiology since the discovery of the x-ray, ARRS maintains its mission of improving health through a community committed to advancing knowledge and skills with the world’s longest continuously published radiology journal—American Journal of Roentgenology—the ARRS Annual Meeting, InPractice magazine, topical symposia, myriad multimedia educational materials, as well as awarding scholarships via The Roentgen Fund®.
MEDIA CONTACT:
Logan K. Young, PIO
44211 Slatestone Court
Leesburg, VA 20176
703-858-4332
Journal
American Journal of Roentgenology
Method of Research
Observational study
Subject of Research
People
Article Title
Utility of Noncancerous Chest CT Features for Predicting Overall Survival and Noncancer Death in Patients With Stage I Lung Cancer Treated With Stereotactic Body Radiotherapy
Article Publication Date
13-Apr-2022
COI Statement
Dr. Fintelmann received salary support from the American Roentgen Ray Society during the study period.