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Incidental findings in routine CT scans can predict CVD
Gondrie M. Radiology. 10.1148/radiol. 10100054.
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Subclinical ancillary aortic findings on chest CT scans can be strong predictors of CVD risk, new study data suggest.
“The results of this study show that radiologists can predict CVD fairly well using incidental findings of calcifications of the aortic wall on CT, along with minimal patient information, such as age, gender and the reason for the CT,” said Martijn J. A. Gondrie, MD, of University Medical Center Utretch, The Netherlands, in a press release. “Ultimately, this easily executed extra risk stratification has the potential to reduce future heart attacks or other CV events.”
Researchers for the Prognostic Value of Ancillary Information in Diagnostic Imaging (PROVDI) study examined 817 patients who underwent CT scans for non-CV indications and 347 patients who experienced a CV event during the 17-month follow-up period. Patients were graded for incidental aortal findings, including calcifications, plaques, elongations and irregularities.
Each aortic abnormality was predictive of CV events (c index range, 0.70–0.72; goodness of-fit P value range, 0.45–0.76). A predictive model incorporating the sum score for each type of abnormality was most predictive (c index, 0.72; goodness of-fit P=.47) and was ultimately selected by the researchers as their model of choice.
The researchers validated the sum total model using an external data set and reported good performance (c index, 0.71; goodness-of-fit P=.25; sensitivity, 46%; specificity, 76%).
The study is the first “of its scale and scope that seeks to investigate the potential of incidental findings to predict future disease and thus identify patients at risk,” Gondrie said. “It generates the much-needed insights that allow more effective utilization of the increasing amount of diagnostic information, and it could potentially change the way radiologists contribute to the efficiency of daily patient care.”
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