Automated assessment of longitudinal biomarker changes at abdominal CT: correlation with subsequent cardiovascular events in an asymptomatic adult screening cohort.

Background: Cardiovascular (CV) disease is a major public health concern, and automated methods can potentially capture relevant longitudinal changes on CT for opportunistic CV screening purposes. Methods: Fully-automated and validated algorithms that quantify abdominal fat, muscle, bone, liver, and...

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Published in:Abdominal Radiology Vol. 46; no. 6; pp. 2976 - 2985
Main Authors: Graffy, Peter M., Summers, Ronald M., Perez, Alberto A., Sandfort, Veit, Zea, Ryan, Pickhardt, Perry J.
Format: Journal Article
Published: Springer Nature Jun2021
Online Access:View this record in EBSCOhost
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      dt: Jun2021
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      pub: Springer Nature
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        10.1007/s00261-020-02885-w
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        atl: Automated assessment of longitudinal biomarker changes at abdominal CT: correlation with subsequent cardiovascular events in an asymptomatic adult screening cohort.
      aug:
        au:
          Graffy, Peter M.
          Summers, Ronald M.
          Perez, Alberto A.
          Sandfort, Veit
          Zea, Ryan
          Pickhardt, Perry J.
        affil: Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
      sug:
      ab: Background: Cardiovascular (CV) disease is a major public health concern, and automated methods can potentially capture relevant longitudinal changes on CT for opportunistic CV screening purposes. Methods: Fully-automated and validated algorithms that quantify abdominal fat, muscle, bone, liver, and aortic calcium were retrospectively applied to a longitudinal adult screening cohort undergoing serial non-contrast CT examination between 2005 and 2016. Downstream major adverse events (MI/CVA/CHF/death) were identified via algorithmic EHR search. Logistic regression, ROC curve, and Cox survival analyses assessed for associations between changes in CT variables and adverse events. Results: Final cohort included 1949 adults (942 M/1007F; mean age, 56.2 ± 6.2 years at initial CT). Mean interval between CT scans was 5.8 ± 2.0 years. Mean clinical follow-up interval from initial CT was 10.4 ± 2.7 years. Major CV events occurred after follow-up CT in 230 total subjects (11.8%). Mean change in aortic calcium Agatston score was significantly higher in CV(+) cohort (591.6 ± 1095.3 vs. 261.1 ± 764.3), as was annualized Agatston change (120.5 ± 263.6 vs. 46.7 ± 143.9) (p < 0.001 for both). 5-year area under the ROC curve (AUC) for Agatston change was 0.611. Hazard ratio for Agatston score change > 500 was 2.8 (95% CI 1.5–4.0) relative to < 500. Agatston score change was the only significant univariate CT biomarker in the survival analysis. Changes in fat and bone measures added no meaningful prediction. Conclusion: Interval change in automated CT-based abdominal aortic calcium load represents a promising predictive longitudinal tool for assessing cardiovascular and mortality risks. Changes in other body composition measures were less predictive of adverse events.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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