Top Line: Rad oncs spend a lot of effort minimizing cardiac radiation exposure but perhaps could do more to identify for whom a cardiac event relative risk increase is clinically meaningful.
The Study: A thought-provoking retrospective cohort of 207 women age ≥65 years treated with adjuvant breast radiotherapy evaluated whether visually assessed coronary artery calcification on noncontrast CT simulation imaging was predictive of subsequent ischemic heart disease. Overall, 43% (n=89) had no calcification, 29% (n=60) had mild calcification, and 28% (n=58) had extensive calcification. Ultimately six patients (3%) developed ischemic heart disease at a median of 5 (range 2-8) years. And all six had extensive calcs at sim, translating to a 10% risk (6/58) with versus 0% risk (0/149) without extensive calcs. In other words, extensive calcifications on CT sim corresponded to an age-adjusted OR of 22 for ischemic heart disease.
TBL: A quick visual assessment of coronary artery calcification on available CT simulation imaging could serve as a simple (and free!) trigger for cardiovascular risk assessment and preventive care, particularly when extensive calcification is apparent. | Golomb, Pract Radiat Oncol 2026
The Study: A thought-provoking retrospective cohort of 207 women age ≥65 years treated with adjuvant breast radiotherapy evaluated whether visually assessed coronary artery calcification on noncontrast CT simulation imaging was predictive of subsequent ischemic heart disease. Overall, 43% (n=89) had no calcification, 29% (n=60) had mild calcification, and 28% (n=58) had extensive calcification. Ultimately six patients (3%) developed ischemic heart disease at a median of 5 (range 2-8) years. And all six had extensive calcs at sim, translating to a 10% risk (6/58) with versus 0% risk (0/149) without extensive calcs. In other words, extensive calcifications on CT sim corresponded to an age-adjusted OR of 22 for ischemic heart disease.
TBL: A quick visual assessment of coronary artery calcification on available CT simulation imaging could serve as a simple (and free!) trigger for cardiovascular risk assessment and preventive care, particularly when extensive calcification is apparent. | Golomb, Pract Radiat Oncol 2026