Michael Lu

M.D., M.P.H.

The General Hospital Corporation d/b/a Massachusetts General Hospital

Co-Director, Cardiovascular Imaging Research Center

NLST (Learn more about this study)

NLST-367

Oct 25, 2017

Deep learning and other automated techniques for predicting incident cardiovascular death and cancer from lung cancer screening CT

The Centers for Medicare & Medicaid Services (CMS) recently approved lung cancer screening with chest computed tomography (CT), based on evidence from the National Lung Screening Trial (NLST) that screening reduces lung cancer mortality. CMS defines lung cancer screening eligibility as persons aged 55-77 who are current or recent (≤15 years) former smokers with a ≥30 pack-year smoking history. While these eligibility criteria target those at highest risk of lung cancer, smoking and age are also important risk factors for atherosclerotic cardiovascular disease (ASCVD) and other types of cancer. In fact in the Framingham Heart Study we found that ASCVD is more common than lung cancer in the screening-eligible population.

Non ECG-gated lung screening CT permits measurement of coronary artery calcification (CAC) and ectopic fat depots, which we and others have demonstrated are important predictors of cardiovascular death and cancer. CTs also contain information about the heart, blood vessels, and other thoracic and upper abdominal anatomy. While these data are available on every lung screening CT, they are infrequently used in clinical care due to lack of time, equipment, and/or expertise. We propose to develop deep learning and other automated techniques to quantify these parameters and predict cardiovascular death and cancer.