Modified Carotid Calcium Score on Pre-Radiotherapy CT Predicts Cerebrovascular Events in Oropharyngeal Cancer Survivors
Year: 2026
Type: dataset
Abstract: Consecutive patients diagnosed with OPC who were treated with RT between 2016 and 2019 at a tertiary center were identified from the Stiefel MD Anderson Oropharyngeal Cancer Cohort. Baseline characteristics including age, sex, tumor laterality and site, RT dose, cardiovascular risk factors, cardiovascular disease history, and cerebrovascular events were extracted from the electronic medical record.Pre-therapy standard-of-care CT scans of the neck with intravenous contrast were reviewed. The scans were analyzed using the syngo.via CT Cardiac software (Siemens Healthcare, Erlangen, Germany), a platform originally designed to quantify coronary artery calcium. The median slice thickness was 1.3 mm. The software's Hounsfield unit (HU) threshold for identifying calcific plaque was adjusted from the standard 130 HU to 230 HU to distinguish calcification from intravascular contrast enhancement, yielding a modified Agatston score (modified Agatston units [mAU]). This threshold was determined empirically by reviewing a pilot sample of 10 patients and incrementally increasing the HU threshold until the software no longer identified intravascular contrast as calcified plaque by visual assessment; 230 HU was the lowest threshold at which complete separation of contrast from calcification was achieved. The common and internal carotid arteries were evaluated bilaterally from the origin of the common carotid artery to the C1 vertebral level; the external carotid artery was excluded because it does not supply the cerebral circulation. Each individual plaque was contoured manually by a single observer.The primary endpoint was time to TIA or ischemic stroke post-RT. TIA was defined as a transient episode of focal neurological dysfunction caused by cerebral ischemia, without evidence of acute infarction on neuroimaging.
Source: Figshare
Authors: Triantafyllou, Efthymios, Kapadia, Taher K., Song, Juhee, Abe, Jun-ichi, Moreno, Amy C., Naser, Mohamed A., Hutcheson, Katherine A, Rosenthal, David I., Palaskas, Nicolas, Zaha, Vlad, Mouhayar, Elie, Addison, Daniel, Fuller, Clifton D., Gladish, Gregory, Deswal, Anita, Koutroumpakis, Efstratios
Language: English
Topic: Head and Neck Cancer Studies
Subfield: Otorhinolaryngology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7164348773