The role of imaging in defining cardiovascular risk to help cancer patient management: a scoping review.

IF 4.5 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Insights into Imaging Pub Date : 2025-02-17 DOI:10.1186/s13244-025-01907-9
Roberto Farì, Giulia Besutti, Pierpaolo Pattacini, Guido Ligabue, Francesco Piroli, Francesca Mantovani, Alessandro Navazio, Mario Larocca, Carmine Pinto, Paolo Giorgi Rossi, Luigi Tarantini
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Abstract

Objective: This scoping review explores the potential role of cancer-staging chest CT scans in assessing cardiovascular (CV) risk in cancer patients. It aims to evaluate: (1) the correlation between non-gated chest CT and the conventional Agatston score from cardiac CT; (2) the association between coronary calcium scores from non-gated chest CT and CV risk in non-oncological patients; (3) the link between coronary calcium assessed by non-gated chest CT and CV events or endothelial damage in cancer patients.

Methods: Three different searches were performed on PubMed, according to the three steps described above. Both original articles and systematic reviews were included.

Results: Many studies in the literature have found a strong correlation between coronary calcium scores from non-gated chest CTs and the conventional Agatston scores from gated cardiac CTs. Various methodologies, including Agatston scoring, ordinal scoring, and the "extent" and "length" methods, have been successfully adapted for use with non-gated chest CTs. Studies show that non-gated scans, even those using iodinated contrast, can accurately assess coronary calcification and predict CV risk, with correlations as high as r = 0.94 when compared to cardiac CTs. In oncological settings, studies demonstrated a significant link between coronary calcium levels on non-gated chest CTs and higher CV risk, including MACE and overall mortality.

Conclusions: Radiological assessment of coronary calcium on non-gated CT scans shows potential for improving CV risk prediction.

Critical relevance statement: Non-gated chest CT scans can detect endothelial damage in cancer patients, highlighting the need for standardized radiological practices to assess CV risks during routine oncological follow-up, thereby enhancing radiology's role in comprehensive cancer care.

Key points: Cancer therapies improve outcomes but increase cardiovascular risk, requiring balanced management. Coronary calcification on non-gated CT correlates with Agatston scores, predicting cardiovascular risk. Routinely performed CTs predict cardiovascular risk, optimizing the management of cancer patients.

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影像学在确定心血管风险以帮助癌症患者管理中的作用:范围综述。
目的:本综述探讨了癌症分期胸部CT扫描在评估癌症患者心血管(CV)风险中的潜在作用。本研究旨在评估:(1)非门控胸部CT与常规心脏CT Agatston评分的相关性;(2)非肿瘤患者非门控胸部CT冠状动脉钙化评分与CV风险的相关性;(3)非门控胸部CT评估的冠状动脉钙与癌症患者心血管事件或内皮损伤之间的联系。方法:根据上面描述的三个步骤,在PubMed上进行三种不同的搜索。包括原创文章和系统综述。结果:许多文献研究发现,非门控胸部ct的冠状动脉钙评分与门控心脏ct的常规Agatston评分之间存在很强的相关性。各种方法,包括Agatston评分法、序数评分法、“范围”法和“长度”法,已经成功地应用于非门控胸部ct。研究表明,非门控扫描,甚至那些使用碘造影剂的扫描,可以准确地评估冠状动脉钙化和预测心血管风险,与心脏ct相比,相关性高达r = 0.94。在肿瘤学方面,研究表明,非门控胸部ct显示的冠状动脉钙水平与较高的心血管风险(包括MACE和总死亡率)之间存在显著联系。结论:在非门控CT扫描上对冠状动脉钙的放射学评估显示了改善CV风险预测的潜力。关键相关性声明:非门控胸部CT扫描可以检测癌症患者的内皮损伤,强调在常规肿瘤随访中需要标准化的放射学实践来评估心血管风险,从而增强放射学在综合癌症治疗中的作用。重点:癌症治疗改善了预后,但增加了心血管风险,需要平衡管理。非门控CT上冠状动脉钙化与Agatston评分相关,预测心血管风险。常规ct预测心血管风险,优化癌症患者的管理。
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来源期刊
Insights into Imaging
Insights into Imaging Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
7.30
自引率
4.30%
发文量
182
审稿时长
13 weeks
期刊介绍: Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere! I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe. Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy. A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field. I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly. The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members. The journal went open access in 2012, which means that all articles published since then are freely available online.
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