Lung cancer screening has popularized the use of low-dose chest CT. While lung cancer is a major killer across the globe, these scans offer potential for detecting other degenerative diseases with prognostic implications. In particular, low-dose chest CT allows the identification of early indicators for coronary artery disease (CAD) and chronic obstructive pulmonary disease (COPD) – diseases that are also in the top ten of global causes of death. Observational studies have shown associations between imaging biomarkers for CAD (manifested as coronary calcification) and COPD (quantified by emphysema severity), and subsequent outcomes. Early detection of degenerative diseases beyond lung cancer provide opportunities for early interventions such as preventive cardiovascular medication.
If, when, and how to evaluate early CT signs of diseases beyond lung nodules and lung cancer are topics of ongoing debate. With burgeoning imaging biomarkers, radiologists are confronted with an increasing workload, while there are limited guidelines on management of ‘incidental’ findings on low dose chest CT. In this workshop, the current evidence for the evaluation of early signs of degenerative diseases on low dose chest CT is discussed. Furthermore, the pivotal role of automated AI software for chest CT imaging biomarkers is elucidated, also based on some cases. Finally, recent recommendations for evaluating and reporting important incidental findings on low-dose chest CT are highlighted.