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European Radiology

, Volume 29, Issue 2, pp 932–940 | Cite as

Is the epicardial adipose tissue area on non-ECG gated low-dose chest CT useful for predicting coronary atherosclerosis in an asymptomatic population considered for lung cancer screening?

  • Kyu-Chong Lee
  • Hwan Seok YongEmail author
  • Jaewook Lee
  • Eun-young Kang
  • Jin Oh Na
Cardiac

Abstract

Objects

The purpose was to determine whether the epicardial adipose tissue (EAT) area on low-dose chest CT (LDCT) could be used to predict coronary atherosclerosis in an asymptomatic population considered for lung cancer screening.

Methods

Subjects aged 55-80 years with smoking history who underwent both LDCT and coronary CT angiography (CCTA) were retrospectively enrolled. Correlation between the EAT volume in CCTA and EAT area in LDCT was evaluated. Coronary risk factors including the body surface area (BSA) indexed EAT area were compared between coronary plaque negative and positive groups. Significant factors for predicting coronary atherosclerosis were analyzed with logistic regression analysis. Receiver-operating characteristic curve analysis was performed to determine the cutoff value.

Results

A total of 438 subjects were enrolled, including 299 subjects with coronary atherosclerosis. There was a good correlation between the EAT volume in CCTA and EAT area in LDCT (ρ = 0.712, p < 0.001). There were significant differences in age, systolic blood pressure, all BSA indexed EAT area, sex, and hypertension between plaque negative and positive groups. In multivariate logistic regression for the BSA indexed EAT area in LDCT at the RCA level, sex (OR: 11.168, 95% CI: 2.107-59.201, p = 0.005), systolic blood pressure (OR: 1.021, 95% CI: 1.005-1.036, p = 0.009), hypertension (OR: 1.723, 95% CI: 1.103-2.753, p = 0.017), and EAT area (OR: 1.273, 95% CI: 1.154-1.405, p < 0.001) were significant. The area under the curve of the BSA indexed EAT area in LDCT at the RCA level for coronary atherosclerosis was 0.657, and the cut-off value was 7.66 cm2/m2.

Conclusion

The EAT area in LDCT could be used to predict coronary atherosclerosis in an asymptomatic population considered for lung cancer screening.

Key Points

• To quantify EAT, the EAT area in LDCT can be used instead of the EAT volume in CCTA.

• The EAT area measured in LDCT can be used as a predictor of coronary artery disease.

• The extensive CAD group tended to have a greater EAT area than the non-extensive CAD group.

Keywords

Coronary artery disease Pericardium Adipose tissue Computed tomography angiography Multidetector computed tomography 

Abbreviations and acronyms

A_CCTA

EAT area in CCTA

A_LDCT

EAT area in LDCT

ALM_LDCT

EAT area in LDCT at LM

ARCA_LDCT

EAT area in LDCT at RCA

AUC

Area under the curve

BMI

Body mass index

BSA

Body surface area

CAD

Coronary artery disease

CCTA

Coronary CT angiography

CIs

Confidence intervals

CT

Computed tomography

DBP

Diastolic blood pressure

EAT

Epicardial adipose tissue

HDL

High-density lipoprotein

HU

Hounsfield units

IRB

Institutional Review Board

LDCT

Low-dose chest computed tomography

LDL

Low-density lipoprotein

LM

Left main coronary artery

MI

Myocardial infarction

MRI

Magnetic resonance imaging

NLST

National Lung Screening Trial

OR

Odds ratios (ORs)

RCA

Right coronary artery

ROC

Receiver-operating characteristic

SBP

Systolic blood pressure

USPSTF

US Preventive Services Task Force

V_CCTA

EAT volume in CCTA

Notes

Funding

The authors state that this work has not received any funding.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Hwan Seok Yong.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• Retrospective

• Case-control study

• Performed at one institution

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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  • Kyu-Chong Lee
    • 1
  • Hwan Seok Yong
    • 1
    • 2
    Email author
  • Jaewook Lee
    • 1
  • Eun-young Kang
    • 1
  • Jin Oh Na
    • 3
  1. 1.Departments of Radiology, College of MedicineKorea UniversitySeoulKorea
  2. 2.Korea University Guro HospitalSeoulKorea
  3. 3.Departments of cardiology, College of MedicineKorea UniversitySeoulKorea

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