Comparison between the Computed Tomography (CT) Coronary Angiography by Using “Coronary Artery Disease - Reporting and Data System (CAD-RADS)” and the Conventional Coronary Angiography in Assessment of the Coronary Artery Stenosis Severity

Abstract

oronary computed tomography angiography (CCTA) is established as the first-line diagnostic imaging tool to exclude coronary artery disease (CAD) at low to intermediate risk. Reporting and interpretation of the findings gap between the referring physicians and radiologist are wide. Using the CAD-RADS in the interpreting the CT angiographic findings added more sharpness and comprehensiveness in patient management plan, and this achieved the main goals of the CAD-RADS in decreasing the variability between readers and enhance communication between interpreting and referring doctors, which affects the best patient care outcome. This study included 24 patients underwent computed tomography coronary angiography and conventional coronary angiography and revealed per-patient sensitivity and specificity of 92.86% and 90% respectively. The positive predictive value and negative predictive value were 92.86% and 90% respectively while the overall accuracy was 91.67%. On per-segment evaluation, the kappa coefficient values of most of the scanned vessels and segments were ranging between 0.81 and 1 that indicated almost perfect agreement. On the other hand, only few segments (i.e. 1st diagonal branch of the left anterior descending artery and the distal segment of the right coronary artery) showed sustained agreement with kappa coefficient value ranging between 0.61 to 0.80.