AI machine learning tools offer increasing ability to extract secondary analysis from imaging studies, which translates to meaningful disease insight that was previously overlooked. Incidental findings are a term used to represent abnormalities that were noticed during the interpretation of an imaging exam that are unrelated to the primary health concern. One such finding that has been labeled “incidental” by traditional breast radiologists is breast arterial calcification. Breast arterial calcium (BAC) is infrequently reported and, to our knowledge, no established quantification or scoring guidelines exist...

Study Population:We retrospectively analyzed 2D mammograms and CT studies from 1449 women (mean age 60 years +/- 11 [SD]) with known CT examinations of the head, neck, chest, abdomen, or pelvis within 12 months of the mammogram date.Quantitative BAC Analysis:A deep learning AI quantitative BAC model was employed, trained on an internal dataset of 2D mammograms. The model detects BAC based on expert radiologist annotation and provides a score of 0-5, considering the total area of BAC and density, where: 0: no BAC visible 1:...

The rate of clinically significant atherosclerotic disease in large and medium vessels was 31.0% (95% CI: 23.7% - 39.4%) when the BAC score was 3 or more greater compared to a rate of 11.0% (95% CI: 9.4% - 12.8%) when the BAC score was less than 3, an increase of 20.0% (95% CI: 11.9% - 28.1%, p < 0.001). Sensitivity was 21.8% (95% CI: 16.4% - 28.2%), Specificity 92.9% (95% CI: 91.4% - 94.2%), and Accuracy 83.8% (95% CI: 81.8% - 85.6%). [Fig 7]

BAC modeling is a viable companion to traditional mammography, as it can be performed with high accuracy and within minutes of the exam. Moreover, a quantitative BAC score can offer insight into the presence or absence of atherosclerotic calcifications within other medium and large vessels in the body. In our model, quantitative BAC assessment predicted a higher rate of clinically significant atherosclerotic disease in large and medium vessels when BAC score was 3 or higher. In a sense, the presence and amount of calcium within...

C. Parghi: Nothing to disclose J. W. Hoffmeister: Shareholder: icad J. Go: Shareholder: iCAD J. Pantleo: Nothing to disclose N. S. Gonzalez: Nothing to disclose Z. Zhang: Nothing to disclose A. Sharma: Nothing to disclose W. Zhang: Shareholder: iCAD

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