2016 SCCT/STR guidelines for coronary artery calcium scoring of noncontrast noncardiac chest CT scans: A report of the Society of Cardiovascular Computed.

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2016 SCCT/STR guidelines for coronary artery calcium scoring of noncontrast noncardiac chest CT scans: A report of the Society of Cardiovascular Computed Tomography and Society of Thoracic Radiology Harvey S. Hecht, Paul Cronin, Michael J. Blaha, Matthew J. Budoff, Ella A. Kazerooni, Jagat Narula, David Yankelevitz, Suhny Abbara Journal of Cardiovascular Computed Tomography Volume 11, Issue 1, Pages 74-84 (January 2017) DOI: 10.1016/j.jcct.2016.11.003 Copyright © 2016 Society of Cardiovascular Computed Tomography Terms and Conditions

Fig. 1 United States estimates, and overlap, of CAC and lung scan eligible patients. The number of eligible patients in the United States is estimated at 33 million for CAC scanning (orange)36 and 7 million for lung scanning (yellow).27 Excluding lung scan eligible patients who have established coronary disease (5.3%, unpublished data from the I-ELCAP database) yields an overlap of 6.6 million lung scan patients who would be expected to benefit from CAC scanning. Reprinted with permission of Oxford University Press from Hecht HS, Henschke CI, Yankelevitz D, Fuster V, Narula J. Combined Detection of Coronary Artery Disease and Lung Cancer. Eur Heart J 2014: 35:2792–6. Journal of Cardiovascular Computed Tomography 2017 11, 74-84DOI: (10.1016/j.jcct.2016.11.003) Copyright © 2016 Society of Cardiovascular Computed Tomography Terms and Conditions

Fig. 2 American College of Radiology National Radiology Data Registry- Lung Cancer Screening Registry (ACR NRDR-LCSR). Journal of Cardiovascular Computed Tomography 2017 11, 74-84DOI: (10.1016/j.jcct.2016.11.003) Copyright © 2016 Society of Cardiovascular Computed Tomography Terms and Conditions

Fig. 3 Combined gated heart and lung scan. A 65 year old asymptomatic male smoker with 40 pack year history and hyperlidemia underwent combined scanning. Images were prospectively acquired in a step and shoot mode on a 256 slice scanner at 120kV and 25 mAs, with 3 mm slice thickness and radiation exposure of 0.95 mSv. Left: Calcium scan demonstrating extensive calcified coronary plaque in the left coronary artery (pink). The total Agatston calcium score was 1467. Riight: Lung window reconstruction reveals a 3mm left lower lobe nodule (green arrow) Bottom: EKG gating signal (yellow dot on R wave). Reprinted with permission of Oxford University Press from Hecht HS, Henschke CI, Yankelevitz D, Fuster V, Narula J. Combined Detection of Coronary Artery Disease and Lung Cancer. Eur Heart J 2014: 35:2792–6. Journal of Cardiovascular Computed Tomography 2017 11, 74-84DOI: (10.1016/j.jcct.2016.11.003) Copyright © 2016 Society of Cardiovascular Computed Tomography Terms and Conditions

Fig. 4 Combined nongated heart and lung scan. A 60 year old asymptomatic male smoker with 35 year pack history underwent combined scanning. Images were acquired at 120 kVp, 25 mAs with a radiation exposure of 0.8 mSv. Left: Nongated calcium scan demonstrating extensive calcified coronary plaque (arrow). The total Agatston score was 823. Right: Lung window reconstruction reveals a left lower lobe mass (arrow) subsequently diagnosed as adenocarcinoma. Reprinted with permission of Oxford University Press from Hecht HS,, Henschke CI, Yankelevitz D, Fuster V, Narula J. Combined Detection of Coronary Artery Disease and Lung Cancer. Eur Heart J 2014: 35:2792–6. Journal of Cardiovascular Computed Tomography 2017 11, 74-84DOI: (10.1016/j.jcct.2016.11.003) Copyright © 2016 Society of Cardiovascular Computed Tomography Terms and Conditions