ArticlePloS one2016
Automatic Coronary Artery Calcium Scoring on Radiotherapy Planning CT Scans of Breast Cancer Patients: Reproducibility and Association with Traditional Cardiovascular Risk Factors.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- Risk of death from cardiovascular disease following breast cancer: a systematic review.Breast cancer research and treatment · 2017Pooled it
- Vascular calcifications in early-breast radiotherapy planning-CT: Opportunistic detection and cardiovascular risk assessment.Clinical and translational radiation oncology · 2026Article
- Coronary Artery Calcium Score as a Predictor of Anthracycline-Induced Cardiotoxicity: The ANTEC Study.Pharmaceuticals (Basel, Switzerland) · 2025Article
- Application of deep learning in automated localization and interpretation of coronary artery calcification in oncological PET/CT scans.The international journal of cardiovascular imaging · 2025Article
- Coronary artery calcium score and other risk factors in patients at moderate and high risk of cancer therapy-related cardiovascular toxicity.Cardio-oncology (London, England) · 2024Article
- Cancer and Cardiovascular Disease: The Conjoined Twins.Cancers · 2024Review
- Role of Cardiac Biomarkers in Non-Small Cell Lung Cancer Patients.Diagnostics (Basel, Switzerland) · 2023Article
- Article
- Associations of Plasma Bioactive Adrenomedullin Levels with Cardiovascular Risk Factors inGeburtshilfe und Frauenheilkunde · 2022Article
- Arterial calcification on preoperative computed tomography imaging as a risk factor for pharyngocutaneous fistula formation after total laryngectomy.Head & neck · 2022Article
- Cardiac Computed Tomography in Cardio-Oncology:JACC. CardioOncology · 2021Review
- Accelerated coronary calcium burden in breast cancer patients after radiotherapy: a comparison with age and race matched healthy women.Radiation oncology (London, England) · 2021Article
- Past, Present, and Future of Radiation-Induced Cardiotoxicity: Refinements in Targeting, Surveillance, and Risk Stratification.JACC. CardioOncology · 2021 · on this mapReview
- Cardiotoxicity screening of long-term, breast cancer survivors-The CAROLE (Cardiac-Related Oncologic Late Effects) Study.Cancer medicine · 2021Article
- Identification of Risk of Cardiovascular Disease by Automatic Quantification of Coronary Artery Calcifications on Radiotherapy Planning CT Scans in Patients With Breast Cancer.JAMA oncology · 2021Article
- Cardiotoxicity of Radiation Therapy: Mechanisms, Management, and Mitigation.Current treatment options in oncology · 2021Review
- Deep Learning for Automatic Calcium Scoring in CT: Validation Using Multiple Cardiac CT and Chest CT Protocols.Radiology · 2020Article
- Article
- Machine Learning for Assessment of Coronary Artery Disease in Cardiac CT: A Survey.Frontiers in cardiovascular medicine · 2019Review
- Impact of automatically detected motion artifacts on coronary calcium scoring in chest computed tomography.Journal of medical imaging (Bellingham, Wash.) · 2018Article
Corrections and comments
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Authors and funding
13 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesCoronary artery calcium (CAC) is a strong and independent predictor of cardiovascular disease (CVD) risk. This study assesses reproducibility of automatic CAC scoring on radiotherapy planning computed tomography (CT) scans of breast cancer patients, and examines its association with traditional cardiovascular risk factors.
methodsThis study included 561 breast cancer patients undergoing radiotherapy between 2013 and 2015. CAC was automatically scored with an algorithm using supervised pattern recognition, expressed as Agatston scores and categorized into five categories (0, 1-10, 11-100, 101-400, >400). Reproducibility between automatic and manual expert scoring was assessed in 79 patients with automatically determined CAC above zero and 84 randomly selected patients without automatically determined CAC. Interscan reproducibility of automatic scoring was assessed in 294 patients having received two scans (82% on the same day). Association between CAC and CVD risk factors was assessed in 36 patients with CAC scores >100, 72 randomly selected patients with scores 1-100, and 72 randomly selected patients without CAC. Reliability was assessed with linearly weighted kappa and agreement with proportional agreement.
results134 out of 561 (24%) patients had a CAC score above zero. Reliability of CVD risk categorization between automatic and manual scoring was 0.80 (95% Confidence Interval (CI): 0.74-0.87), and slightly higher for scans with breath-hold. Agreement was 0.79 (95% CI: 0.72-0.85). Interscan reliability was 0.61 (95% CI: 0.50-0.72) with an agreement of 0.84 (95% CI: 0.80-0.89). Ten out of 36 (27.8%) patients with CAC scores above 100 did not have other cardiovascular risk factors.
conclusionsAutomatic CAC scoring on radiotherapy planning CT scans is a reliable method to assess CVD risk based on Agatston scores. One in four breast cancer patients planned for radiotherapy have elevated CAC score. One in three patients with high CAC scores don't have other CVD risk factors and wouldn't have been identified as high risk.
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