Abstract 13946: Predictive Value of FDG-PET/CT Derived Coronary Artery Calcium Scoring in Non-Small Cell Lung Cancer Patients

Introduction/Background: Coronary artery calcium (CAC) scoring on PET-CT has emerged as a potential prognostic tool in patients with cancer.

Research Question/Hypothesis: CAC determined using non-ECG gated PET-CT data is a useful predictor of major adverse cardiac events (MACE) and overall survival in non-small cell lung cancer (NSCLC) patients.

Goals/Aims: To investigate the association between CAC scores, MACE, and survival outcomes in NSCLC patients.

Methods/Approach: We retrospectively analyzed baseline staging PET-CT (n=130) or CT (n=24), clinical history, demographics, and follow-up survival data of NSCLC patients. Patients were divided into four groups based on their CAC scores according to the 2016 SCCT/STR guidelines. Cox regression analysis was performed to assess the association between CAC score and survival, CAC score and MACE, and smoking history and survival.

Results/Data: The mean age of the population was 66.3 ± 10.8 years with 42.9% never smokers. Of the 154 patients evaluated, 49.3% died during a mean follow-up period of 3.5 years. Cox regression analysis revealed a trend toward improved survival rates of patients with lower CAC scores (P= 0.081 for No/Minimal risk and P= 0.039 for Mild group). Current or prior smoking was significantly associated with decreased survival (P = .013, HR = 1.8). Logistic regression analysis showed a significant inverse relationship between CAC scores and MACE (n=32) for no risk/minimal (P = .001) and mild risk (P < .001) groups. Additionally, there was an inverse association between CAC and number of observed acute MI for no /minimal risk group (P= .02) and mild risk group (P= .003).

Conclusion: Our findings suggest that lower CAC scores, measured at initial staging PET-CT, are associated with decreased MACE and acute MI in NSCLC patients. Further studies are needed to validate these findings and explore the potential of CAC scoring as a routine prognostic tool in NSCLC management.