Pulmonary circulatory system characteristics are associated with future lung cancer risk

© 2023 American Association of Physicists in Medicine..

BACKGROUND: Most of the subjects eligible for annual low-dose computed tomography (LDCT) lung screening will not develop lung cancer for their life. It is important to identify novel biomarkers that can help identify those at risk of developing lung cancer and improve the efficiency of LDCT screening programs.

OBJECTIVE: This study aims to investigate the association between the morphology of the pulmonary circulatory system (PCS) and lung cancer development using LDCT scans acquired in the screening setting.

METHODS: We analyzed the PLuSS cohort of 3635 lung screening patients from 2002 to 2016. Circulatory structures were segmented and quantified from LDCT scans. The time from the baseline CT scan to lung cancer diagnosis, accounting for death, was used to evaluate the prognostic ability (i.e., hazard ratio (HR)) of these structures independently and with demographic factors. Five-fold cross-validation was used to evaluate prognostic scores.

RESULTS: Intrapulmonary vein volume had the strongest association with future lung cancer (HR = 0.63, p < 0.001). The joint model of intrapulmonary vein volume, age, smoking status, and clinical emphysema provided the strongest prognostic ability (HR = 2.20, AUC = 0.74). The addition of circulatory structures improved risk stratification, identifying the top 10% with 28% risk of lung cancer within 15 years.

CONCLUSION: PCS characteristics, particularly intrapulmonary vein volume, are important predictors of lung cancer development. These factors significantly improve prognostication based on demographic factors and noncirculatory patient characteristics, particularly in the long term. Approximately 10% of the population can be identified with risk several times greater than average.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:51

Enthalten in:

Medical physics - 51(2024), 4 vom: 06. Apr., Seite 2589-2597

Sprache:

Englisch

Beteiligte Personen:

Pu, Jiantao [VerfasserIn]
Bandos, Andriy [VerfasserIn]
Yu, Tong [VerfasserIn]
Wang, Renwei [VerfasserIn]
Yuan, Jian-Min [VerfasserIn]
Herman, James [VerfasserIn]
Wilson, David [VerfasserIn]

Links:

Volltext

Themen:

Image biomarker
Journal Article
Low dose CT
Lung cancer risk
Pulmonary circulatory system

Anmerkungen:

Date Completed 05.04.2024

Date Revised 06.04.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1002/mp.16930

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM366499416