A new study in the American Journal of Roentgenology (AJR) offers crucial reference data for healthcare practitioners developing national lung cancer screening programs. The findings underscore the importance of routine coronary artery calcification (CAC) evaluation, according to the study authors.

“For Korea’s national lung cancer screening program, major adverse cardiovascular event (MACE) occurrence increased significantly with increasing CAC severity, whether assessed by visual analysis or AI software,” says Won Gi Jeong, MD, PhD, from the department of radiology at Chonnam National University, Hwasun Hospital in South Korea. Still, Jeong acknowledges that this study was “limited by the large sex imbalance for Korea’s national lung cancer screening program.”

Jeong and his colleagues’ AJR-accepted manuscript included 1,002 patients (mean age, 62.4 years; 994 men, 8 women) who underwent LDCT at two Korean medical centers during a national lung cancer screening program (April 2017-May 2023). Two radiologists independently assessed CAC presence and severity via visual analysis, consulting a third radiologist for resolution. Two AI software applications were also used to assess CAC presence and severity, while MACE occurrences were identified by EMR review.

Ultimately, prevalence on LDCT was 53.4 for visual analysis, and 56.6% and 60.1% for two AI software applications. The incidence of MACE was significantly associated with increasing CAC severity, as assessed by visual analysis and both AI applications (all p <.001).

Featured image: Left: Axial CT image shows coronary artery calcification (CAC). CAC was assessed as severe by consensus visual analysis. Right: Output of CAC analysis by artificial intelligence (AI) software I (AVIEW CAC). CAC score was 376.0, consistent with moderate CAC. Bottom: Output of CAC analysis by AI software II (syngo Calcium Scoring). CAC score was 407.2, consistent with severe CAC.