Abstract
BackgroundMultidetector computed tomography angiography (MDCT) is a non-invasive examination for coronary artery disease. Coronary artery disease reporting and data system (CAD-RADS) is a structured reporting system that successfully facilitated communication with clinicians. Our study aimed to assess the accuracy as well as the agreement of the CAD-RADS system with the conventional angiography results.Results48 patients were enrolled in this prospective study, all patients underwent MDCT coronary angiography and conventional coronary artery angiography. An excellent inter method agreement between coronary CT angiography (CCTA) and conventional coronary angiography was noted for the left main trunk (LMT) with k = 1 (p < 0.001). An excellent inter method agreement was found for the proximal, mid- and distal segments of the left anterior descending artery (LAD) and the second diagonal segment, with k = 1, 0.842 0.886 and 0.886, respectively (p < 0.001). A good agreement was noted at the first diagonal segment with k = 0.765 (p < 0.001). An excellent inter-method agreement was found for the proximal, mid- and distal segments of the left circumflex artery (LCx) and the obtuse marginal branch, with k = 0.838, 0.846, 1 and 0.846, respectively (p < 0.001). An excellent agreement was found for the proximal and mid-segments of the right coronary artery (RCA) and the posterior descending artery, with k = 1 for all segments (p < 0.001), yet a good agreement was noted at its distal segment with k = 0.782 (p < 0.001). The overall per-patient sensitivity, specificity and accuracy of the CT coronary angiography were 92.9%, 90% and 91.7% respectively.ConclusionsThe CAD-RADS algorithm and invasive coronary angiography agreed perfectly; thus, CT coronary angiography can be used as the first screening test and the invasive coronary angiography can be spared for cases requiring intervention.
Highlights
Multidetector computed tomography angiography (MDCT) is a non-invasive examination for coronary artery disease
Many previous studies have assessed the accuracy of coronary Computed tomography (CT) angiography yet, very limited studies considered the Coronary artery disease (CAD)-RADS classification system per se [5,6,7] and the CAD-RADS system is widely used by many institutes, it is still not widely accepted officially as a reporting system for coronary CT angiography across the globe [8]
Per‐artery analysis As regards the agreement of the findings detected by CT angiography and conventional angiography at the left main trunk (LMT), there was an excellent agreement between CT coronary angiography and conventional coronary angiography as regarding the 46 non-significant (95.8%) and 2 (4.2%) significant lesions at each of the proximal, mid- and distal segments
Summary
Multidetector computed tomography angiography (MDCT) is a non-invasive examination for coronary artery disease. Coronary artery disease reporting and data system (CAD-RADS) is a structured reporting system that successfully facilitated communication with clinicians. Our study aimed to assess the accuracy as well as the agreement of the CAD-RADS system with the conventional angiography results. Coronary artery disease (CAD) is considered to be the most common cause of death worldwide rendering the proper diagnosis and appropriate management of utmost. To unify the reporting system and to link diagnostic data with patient management, Curye et al [4] developed coronary artery disease reporting and data system (CADRADS). This study aimed to assess the accuracy as well as the agreement of the CAD-RADS system with the conventional angiography results which will support the concept of replacing the invasive conventional angiography by CT angiography especially at stable cases Structured reporting has emerged as the best choice for reporting, attempting to provide a precise answer to a clinician’s question and sharing in the patient management by providing the appropriate step management based on radiological imaging [9].
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