Al-Antary Nada, Hirko Kelly A, Cassidy-Bushrow Andrea E, Zarins Katie R, Simoff Mike J, Song Thomas, Cohen Avi, Neslund-Dudas Christine
Department of Public Health Sciences, Henry Ford Health, Detroit, MI; Henry Ford Cancer, Henry Ford Health, Detroit, MI; Michigan State University Health Sciences, East Lansing, MI.
Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI; Michigan State University Health Sciences, East Lansing, MI.
Chest. 2025 Sep;168(3):719-736. doi: 10.1016/j.chest.2025.03.031. Epub 2025 Apr 18.
Coronary artery calcification (CAC) can be a significant incidental finding on low-dose CT scans performed for lung cancer screening (LCS). CAC presence and grade hold important diagnostic and preventive value, particularly in patients without previously recognized coronary artery disease.
What is the prevalence of CAC as an incidental finding on LCS CT scans across prior studies?
A literature review was conducted using the PubMed database to identify studies investigating CAC identified on LCS CT scans. The review included articles published in English from January 2012 through March 2024. The search query used 3 main keywords: CAC, LCS, and incidental finding.
The initial search resulted in 256 abstracts screened for eligibility, resulting in 32 articles included in the final review. CAC presence across included studies varied from 14.8% to 98%. CAC most commonly was reported as mild in grade, among 46.9% of studies. Most studies were conducted among predominantly White male participants. Finally, only 6 articles provided information on downstream interventions for patients with newly detected CAC.
CAC, a predictive risk factor for cardiovascular events and mortality, is a frequently detected incidental finding on LCS CT scans, with substantial variation in presence across studies. Identification of CAC on LCS CT scans could inform clinical decisions to reduce patients' overall cardiovascular risk. These findings underscore the significance of standardizing the documentation and management of CAC in LCS. Finally, future studies should include greater race diversity.
在进行肺癌筛查（LCS）的低剂量CT扫描中，冠状动脉钙化（CAC）可能是一个重要的偶然发现。CAC的存在和分级具有重要的诊断和预防价值，特别是在先前未被诊断出患有冠状动脉疾病的患者中。
在先前的研究中，LCS CT扫描偶然发现CAC的患病率是多少？
使用PubMed数据库进行文献综述，以确定调查LCS CT扫描中发现的CAC的研究。该综述纳入了2012年1月至2024年3月以英文发表的文章。搜索查询使用了3个主要关键词：CAC、LCS和偶然发现。
初步搜索产生了256篇摘要以供筛选是否符合条件，最终综述纳入了32篇文章。纳入研究中CAC的存在率从14.8%到98%不等。在46.9%的研究中，CAC最常被报告为轻度分级。大多数研究主要在白人男性参与者中进行。最后，只有6篇文章提供了关于新检测到CAC的患者下游干预措施的信息。
CAC是心血管事件和死亡率的预测风险因素，是LCS CT扫描中经常检测到的偶然发现，各研究中的存在率差异很大。在LCS CT扫描中识别CAC可以为降低患者总体心血管风险的临床决策提供信息。这些发现强调了在LCS中标准化CAC的记录和管理的重要性。最后，未来的研究应纳入更多种族的多样性。
