{"doi":"10.31488/ejrm.149","title":"Pulmonary Circulatory System: A Biomarker for Lung Cancer Development","abstract":"This study aimed to investigate the relationship between the morphology of pulmonary circulatory system and lung cancer development based on low dose computed tomography (LDCT) scans acquired in the screening setting.We analyzed the baseline LDCT scans in the Pittsburgh Lung Screening Study (PLuSS) cohort, including 3,635 patients who underwent screening between 2002 and 2016.The analysis showed that pulmonary circulatory system characteristics, particularly intrapulmonary vein volume, are important predictors of lung cancer development.The joint model of circulatory structures revealed a strong prognostic ability of the intrapulmonary vessel ratio, achieving an AUC of 0.69 (95% CI: 0.66-0.72).Adjusting for non-circulatory parameters, intrapulmonary vessel ratio remained strongly prognostic (p<0.001), with cross-validated combined scores showing substantial improvement in prognostic ability (HR=2.20,95%CI: 2.00-2.43;AUC=0.74,95%CI: 0.71-0.77).The overall composite model, incorporating heart volume and BMI, achieved slightly better prognostic ability with an AUC of 0.76 (95%CI: 0.73-0.78).The addition of circulatory structures allowed identifying approximately 10% of the population with risk several times greater than average, with a 30% risk (95% CI: 0.26-0.35for cumulative incidence) of developing lung cancer within 15 years.These findings suggest that incorporating pulmonary circulatory system characteristics in LDCT screening programs can improve their efficiency in identifying individuals at risk of developing lung cancer, particularly in the long term.","journal":"European Journal of Respiratory Medicine","year":2024,"id":502313,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9576,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-19T02:10:19.647285Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}