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Related Concept Videos

Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT01:25

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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Coronary Artery Disease I: Introduction01:30

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Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
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Coronary Artery Disease IV: Preventive Measures01:26

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Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
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Imaging Studies for Cardiovascular System III: X-Ray01:20

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The most common cardiovascular diagnostic test is an X-ray. It produces images of the heart, blood vessels, and adjacent structures.
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
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Imaging Studies for Cardiovascular System V: CT01:28

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Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
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Acute Coronary Syndrome III: Diagnostic Studies01:30

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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
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Coronary artery calcification-does it predict the CAD-RADS category?

Maryam Moradi1, Ebrahim Rafiei1, Sina Rasti2

  • 1Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, 8174673461, Isfahan, Iran.

Emergency Radiology
|August 3, 2022
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Summary

Coronary calcium scores (CCSs) from cardiac-gated computed tomography (CCT) can predict coronary artery disease reporting and data system (CAD-RADS) categories. This non-invasive method achieves approximately 80% accuracy in identifying significant coronary artery disease.

Keywords:
AtherosclerosisComputed tomography angiographyCoronary artery diseaseVascular calcification

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Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Preventive Cardiology

Background:

  • Coronary artery disease (CAD) is a leading cause of mortality.
  • Cardiac-gated computed tomography (CCT) with coronary calcium scores (CCSs) is a validated method for CAD assessment.
  • Computed tomography angiography (CTA) is often used for definitive CAD diagnosis but involves radiation and contrast agents.

Purpose of the Study:

  • To evaluate the predictive capability of CCSs for coronary artery disease reporting and data system (CAD-RADS) categories.
  • To determine if CCSs can obviate the need for CTA in assessing CAD severity.
  • To establish cut-off values for CCSs to predict significant CAD (CAD-RADS 3-5).

Main Methods:

  • Analysis of CCT and CTA data from 544 patients.
  • Calculation of various CCS metrics: number of calcified regions of interest (ROIs), Agatston score, area, volume, and mass.
  • Comparison of CCS values across CAD-RADS categories (1-5) using ROC curve analysis and logistic regression.
  • Determination of predictive cut-offs for significant CAD.

Main Results:

  • CCSs, particularly the number of calcified ROIs, showed significant differences between CAD-RADS categories.
  • Established cut-offs for predicting significant CAD (CAD-RADS 3-5) were: 9 ROIs, 128 Agatston score, 44 mm² area, 111 mm³ volume, and 22 mg mass.
  • Predictive models achieved 79% accuracy for the most probable CAD-RADS category and 81% for significant/non-significant CAD.

Conclusions:

  • CCSs demonstrate significant potential in predicting CAD-RADS categories with approximately 80% accuracy.
  • These findings suggest CCSs may help stratify patients and potentially reduce the need for CTA in certain cases.
  • Further research into novel calcium indices is warranted to enhance predictive capabilities.