Deep Radiomic Analysis of Coronary Heart Disease with Lung Screening CT

2015年，心血管疾病导致1770万人死亡，占所有死亡人数的三分之一 全球范围内。在2015年死于癌症的880万人中，肺癌占全球死亡人数的169万人。 在美国，2018年肺癌将夺走154,050人的生命，占所有癌症死亡人数的四分之一。 心血管疾病和肺癌都有几个共同的危险因素，包括不健康的饮食模式、肥胖和吸烟。 使用。低剂量计算机断层扫描(LDCT)是一种有效的肺癌筛查技术，可以降低 在那些有大量吸烟史的人中，癌症相关死亡率降低了20%。这样的主题基本上有 患心血管疾病的风险比肺癌高。事实上，接受LDCT肺癌筛查的大多数受试者都有 心血管疾病的中到高风险。伴随而来的心血管疾病筛查将对这些受试者带来深远的好处 不会增加患者的时间、费用或辐射剂量。 该项目的目标是开发心血管发病率和死亡风险的自动化工作流程 (CARMOR)利用肺癌筛查LDCT数据为高危受试者提供“无辐射”心血管疾病的评估 没有成本或时间限制的筛选。我们的中心假设是来自LDCT随访的深层放射组学 扫描和跨不同重建可以有效地提高CARMOR估计的性能。至 验证我们的假设，我们将对CARMOR进行放射组学分析，并进行肺癌筛查 扫描，然后通过来自 相同扫描和连续LDCT扫描可优化预后性能。CARMOR量化方法 在肺部筛查中，LDCT将与患有冠状动脉的多位专科放射科医生进行回顾性验证 以CT血管造影(CCTA)为参考标准。这个项目需要我们来完成 分析了连续LDCT检查以及不同的重建技术和设置。因此，少校 这项具有挑战性的深层放射分析任务需要进行创新和改进。 由于心血管疾病和肺癌的风险因素与生活方式密切相关，该项目的发现可以 也被用来创造可教的时刻，让患者改变更健康的生活方式。在此背景下 医疗保险和医疗补助服务中心(CMS)为肺癌筛查和应激反应提供LDCT报销 关于考虑合并症的重要性，我们及时的项目将对医疗保健产生重大影响 人口众多的国家。在项目结束时，我们将开发一个自动化的评估工作流程 CARMOR肺筛查LDCT加零辐射扫描。我们还将获得研究结果，以实现 个性化的患者教育，以解决不健康的生活方式造成的长期健康危机。我们的研究 将导致对深层次放射组学在心血管疾病筛查中的新理解以及低密度CT重建对 临床实践。

Cardiovascular diseases (CVDs) caused 17.7 million deaths in 2015, accounting for one third of all deaths globally. Amongst 8.8 million cancer-deaths in 2015, lung cancer contributed to 1.69 million deaths worldwide. In the United States, lung cancer will claim 154,050 lives in 2018, representing a quarter of all cancer deaths. Both CVDs and lung cancer share several risk factors, including unhealthy dietary patterns, obesity, and tobacco use. Low-dose Computed Tomography (LDCT), an effective lung cancer screening technique, reduces the cancer-related mortality rate by 20% in those with history of heavy smoking. Such subjects have substantially higher risk of CVDs than lung cancer. Indeed, most subjects undergoing lung cancer screening with LDCT have an intermediate to high risk for CVDs. Concomitant CVD screening will have profound benefits for these subjects at no additional time, cost, or radiation dose to the patient. The goal of the project is to develop an automated workflow of cardiovascular morbidity and mortality risk (CARMOR) evaluation with lung cancer screening LDCT data to provide high-risk subjects a “radiation-free” CVD screening without cost or time constraints. Our central hypothesis is that deep radiomics from LDCT follow-up scans and across different reconstructions can effectively improve the performance of CARMOR estimation. To validate our hypothesis, we will perform radiomics analysis on CARMOR with lung cancer screening LDCT scans, and then further enhance the CARMOR features with complementary image reconstructions from the same scan and serial LDCT scans for optimized prognostic performance. The CARMOR quantification methods in lung screening LDCT will be validated retrospectively against multiple subspecialty radiologists with Coronary Computed Tomography Angiogram (CCTA) as the standard of reference. The project requires us to perform analyses over serial LDCT exams and different reconstruction techniques and settings. Therefore, major innovations and improvements need to be made for this challenging deep radiomic analysis task. Since the risk factors of CVDs and lung cancer are closely related with lifestyle, the findings of the project can also be used to create teachable moments for patients to change towards healthier lifestyles. In context of the Center for Medicare & Medicaid Services (CMS) reimbursement of LDCT for lung cancer screening and stress on the importance of considering co-morbidities, our timely project will have a significant impact on the healthcare of a large population. At the end of the project, we will have developed an automated workflow of assessing CARMOR for lung screening LDCT with zero radiation added. We will also have acquired study results to enable personalized patient education to address the long-term health crisis caused by unhealthy lifestyles. Our studies will lead to new understanding of deep radiomics in CVD screening and the impact of LDCT reconstructions in clinical practice.