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Updated: Jun 22, 2025
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Comparison of coronary CT angiography and invasive coronary angiography results
Muhammed Tekinhatun1, İbrahim Akbudak2, Mehmet Özbek3
1Department of Radiology, Faculty of Medicine, Dicle University, Diyarbakir, Türkiye. mtekinhatun@gmail.com.
Insights
Coronary artery disease (CAD) diagnosis is improved using coronary computed tomography angiography (CCTA) and the CAD-Reporting and Data System (CAD-RADS). CCTA accurately assesses stenosis and is compatible with invasive coronary angiography for treatment planning.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Coronary artery disease (CAD) is a leading global cause of mortality.
- Accurate diagnosis and timely management of CAD are crucial.
- Non-invasive imaging, particularly coronary computed tomography angiography (CCTA), plays a vital role in early CAD detection and treatment strategy development.
Purpose of the Study:
- To evaluate the diagnostic accuracy of the CAD-Reporting and Data System (CAD-RADS) scoring.
- To assess the compatibility between CCTA and invasive coronary angiography (ICA) in patients with suspected CAD.
- To analyze the utility of extracardiac findings identified via CCTA with a wide field of view (FOV).
Main Methods:
- A cohort of 214 patients with suspected CAD underwent both CCTA and ICA between January 2022 and January 2024.
- CAD-RADS scoring was applied to categorize coronary stenosis based on CCTA findings.
- Diagnostic performance metrics including sensitivity, specificity, accuracy, and predictive values were calculated. A wide FOV was used for CCTA to capture extracardiac findings.
Main Results:
- Correlations were observed between hypertension, smoking, calcium score, and high-risk plaques with both CCTA and ICA CAD-RADS scores.
- CCTA demonstrated high sensitivity and negative predictive value for detecting significant stenosis (≥70% and ≥50%).
- Excellent agreement was found between CCTA and ICA in bypass patients, with high sensitivity and NPV for stenosis detection in stented vessels.
Conclusions:
- CAD-RADS, in conjunction with CCTA, is important for CAD diagnosis and guiding treatment decisions.
- CCTA proves effective in evaluating coronary stents and grafts.
- The identification of extracardiac findings using a wide FOV during CCTA offers additional clinical benefits.
Introduction:
Coronary artery disease (CAD) is a leading cause of death worldwide. Accurate diagnosis and management are critical. Non-invasive imaging, such as coronary computed tomography angiography (CCTA), is vital for early diagnosis and treatment planning. This study evaluates the accuracy of CAD-Reporting and Data System (CAD-RADS) scoring and the compatibility between CCTA and invasive coronary angiography (ICA) in patients suspected of having CAD.
Materials And Methods:
From January 1, 2022 to January 15, 2024, 214 patients suspected of CAD underwent both CCTA and ICA. CCTA artifacts led to the exclusion of 32 patients and 128 vessels, leaving 586 vessels for analysis. CAD-RADS scoring categorized coronary stenosis. Diagnostic performance was measured by specificity, sensitivity, accuracy, positive and negative predictive value (NPV). Extracardiac findings were analyzed with a wide field of view (FOV) during CCTA.
Results:
A total of 214 patients (67.3% male, median age 56) were examined. Hypertension, smoking, calcium score, and high-risk plaques correlated with CCTA and ICA CAD-RADS scores; calcium score also related to hypertension, smoking, diabetes, and dyslipidemia (p < 0.05). CCTA showed a sensitivity of 80.8% and NPV of 90.3% for detecting stenosis of 70% or more; for 50% stenosis, sensitivity was 93.5% and NPV 92.1%. Agreement between CCTA and ICA was excellent in bypass patients; stenosis detection in stented patients had 85.7% sensitivity and 96.2% NPV.
Conclusion:
This study highlights the importance of CAD-RADS and CCTA in CAD diagnosis and treatment planning. CCTA effectively evaluates stents and grafts, emphasizing the benefits of extracardiac findings and a wide FOV.
