DOI QR코드

DOI QR Code

Coronary Artery Disease Reporting and Data System: A Comprehensive Review

  • Parveen Kumar (Department of Radiodiagnosis & Imaging, Fortis Escort Heart Institute) ;
  • Mona Bhatia (Department of Radiodiagnosis & Imaging, Fortis Escort Heart Institute)
  • 투고 : 2020.10.23
  • 심사 : 2021.02.07
  • 발행 : 2022.01.27

초록

The Coronary Artery Disease Reporting and Data System (CAD-RADS) is a standardized reporting method for coronary computed tomography angiography (CCTA). It summarizes the findings of CCTA in 6 categories ranging from CAD-RADS 0 (complete absence of coronary artery disease) to CAD-RADS 5 (total occlusion of at least one vessel). It is applied on per patient basis for the highest grade of the stenotic lesion. The CAD-RADS also provides categoryspecific treatment recommendations, helping patient management. The main objectives of the CAD-RADS are to improve the consistency in reporting, facilitate the communication between interpreting and referring clinicians, recommend the best course of patient management, and produce consistent data for quality improvement, research and education. However, CAD-RADS has many limitations, resulting into the misclassification of the observed findings, misinterpretation of the final category, and misguidance for the treatment based upon the single score. In this review, the authors discuss the CAD-RADS categories and modifiers, along with the strengths and limitations of this new classification system.

키워드

참고문헌

  1. Leipsic J, Abbara S, Achenbach S, et al. SCCT guidelines for the interpretation and reporting of coronary CT angiography: a report of the Society of Cardiovascular Computed Tomography guidelines committee. J Cardiovasc Comput Tomogr 2014;8:342-58. 
  2. Abbara S, Arbab-Zadeh A, Callister TQ, et al. SCCT guidelines for performance of coronary computed tomographic angiography: a report of the Society of Cardiovascular Computed Tomography guidelines committee. J Cardiovasc Comput Tomogr 2009;3:190-204. 
  3. Halliburton SS, Abbara S, Chen MY, et al. SCCT guidelines on radiation dose and dose-optimization strategies in cardiovascular CT. J Cardiovasc Comput Tomogr 2011;5:198-224.
  4. Achenbach S, Delgado V, Hausleiter J, Schoenhagen P, Min JK, Leipsic JA. SCCT expert consensus document on computed tomography imaging before transcatheter aortic valve implantation (TAVI)/transcatheter aortic valve replacement (TAVR). J Cardiovasc Comput Tomogr 2012;6:366-80. 
  5. Taylor AJ, Cerqueira M, Hodgson JM, et al. ACCF/SCCT/ACR/AHA/ASE/ASNC/ NASCI/SCAI/SCMR 2010 appropriate use criteria for cardiac computed tomography. A report of the American College of Cardiology Foundation appropriate use criteria task force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance. J Cardiovasc Comput Tomogr 2010;4:407.e1-407.e33. 
  6. Goldstein JA, Chinnaiyan KM, Abidov A, et al. The CT-STAT (coronary computed tomographic angiography for systematic triage of acute chest pain patients to treatment) trial. J Am Coll Cardiol 2011;58:1414-22. 
  7. Litt HI, Gatsonis C, Snyder B, et al. CT angiography for safe discharge of patients with possible acute coronary syndromes. N Engl J Med 2012;366:1393-1403. 
  8. Hoffmann U, Truong QA, Schoenfeld DA, et al. Coronary CT angiography versus standard evaluation in acute chest pain. N Engl J Med 2012;367:299-308. 
  9. Hamilton-Craig C, Fifoot A, Hansen M, et al. Diagnostic performance and cost of CT angiography versus stress ECG--a randomized prospective study of suspected acute coronary syndrome chest pain in the emergency department (CT-COMPARE). Int J Cardiol 2014;177:867-73. 
  10. Cury RC, Abbara S, Achenbach S, et al. CAD-RADS(TM) Coronary Artery Disease - Reporting and Data System. An expert consensus document of the Society of Cardiovascular Computed Tomography (SCCT), the American College of Radiology (ACR) and the North American Society for Cardiovascular Imaging (NASCI). J Cardiovasc Comput Tomogr 2016;10:269-81. 
  11. Abbara S, Blanke P, Maroules CD, et al. SCCT guidelines for the performance and acquisition of coronary computed tomographic angiography: a report of the Society of Cardiovascular Computed Tomography Guidelines Committee: Endorsed by the North American Society for Cardiovascular Imaging (NASCI). J Cardiovasc Comput Tomogr 2016;10:435-49. 
  12. Raff GL, Abidov A, Achenbach S, et al. SCCT guidelines for the interpretation and reporting of coronary computed tomographic angiography. J Cardiovasc Comput Tomogr 2009;3:122-36. 
  13. Motoyama S, Sarai M, Harigaya H, et al. Computed tomographic angiography characteristics of atherosclerotic plaques subsequently resulting in acute coronary syndrome. J Am Coll Cardiol 2009;54:49-57. 
  14. Puchner SB, Liu T, Mayrhofer T, et al. High-risk plaque detected on coronary CT angiography predicts acute coronary syndromes independent of significant stenosis in acute chest pain: results from the ROMICAT-II trial. J Am Coll Cardiol 2014;64:684-92. 
  15. Abdel Razek AAK, Elrakhawy MM, Yossof MM, Nageb HM. Inter-observer agreement of the Coronary Artery Disease Reporting and Data System (CAD-RADSTM) in patients with stable chest pain. Pol J Radiol 2018;83:e151-9. 
  16. Maroules CD, Hamilton-Craig C, Branch K, et al. Coronary artery disease reporting and data system (CAD-RADSTM): Inter-observer agreement for assessment categories and modifiers. J Cardiovasc Comput Tomogr 2018;12:125-30. 
  17. Basha MAA, Aly SA, Ismail AAA, Bahaaeldin HA, Shehata SM. The validity and applicability of CAD-RADS in the management of patients with coronary artery disease. Insights Imaging 2019;10:117. 
  18. Min JK, Labounty TM, Gomez MJ, et al. Incremental prognostic value of coronary computed tomographic angiography over coronary artery calcium score for risk prediction of major adverse cardiac events in asymptomatic diabetic individuals. Atherosclerosis 2014;232:298-304.
  19. Aldrovandi A, Maffei E, Seitun S, et al. Major adverse cardiac events and the severity of coronary atherosclerosis assessed by computed tomography coronary angiography in an outpatient population with suspected or known coronary artery disease. J Thorac Imaging 2012;27:23-8. 
  20. Kang SH, Park GM, Lee SW, et al. Long-term prognostic value of coronary CT angiography in asymptomatic type 2 diabetes mellitus. JACC Cardiovasc Imaging 2016;9:1292-300. 
  21. Xie JX, Cury RC, Leipsic J, et al. The coronary artery disease-reporting and data system (CAD-RADS): prognostic and clinical implications associated with standardized coronary computed tomography angiography reporting. JACC Cardiovasc Imaging 2018;11:78-89. 
  22. Nam K, Hur J, Han K, et al. Prognostic value of coronary artery disease-reporting and data system (CAD-RADS) score for cardiovascular events in ischemic stroke. Atherosclerosis 2019;287:1-7. 
  23. Bittner DO, Mayrhofer T, Budoff M, et al. Prognostic value of coronary CTA in stable chest pain: CAD-RADS, CAC, and cardiovascular events in PROMISE. JACC Cardiovasc Imaging 2020;13:1534-45. 
  24. Muscogiuri G, Chiesa M, Trotta M, et al. Performance of a deep learning algorithm for the evaluation of CAD-RADS classification with CCTA. Atherosclerosis 2020;294:25-32. 
  25. Williams PD. Stent fracture with contemporary coronary stent platforms. EuroIntervention 2014;10:651-2. 
  26. Pflederer T, Marwan M, Schepis T, et al. Characterization of culprit lesions in acute coronary syndromes using coronary dual-source CT angiography. Atherosclerosis 2010;211:437-44. 
  27. Bauer RW, Thilo C, Chiaramida SA, Vogl TJ, Costello P, Schoepf UJ. Noncalcified atherosclerotic plaque burden at coronary CT angiography: a better predictor of ischemia at stress myocardial perfusion imaging than calcium score and stenosis severity. AJR Am J Roentgenol 2009;193:410-8. 
  28. Mangiacapra F, Bressi E, Sticchi A, Morisco C, Barbato E. Fractional flow reserve (FFR) as a guide to treat coronary artery disease. Expert Rev Cardiovasc Ther 2018;16:465-77. 
  29. Hamon M, Geindreau D, Guittet L, Bauters C, Hamon M. Additional diagnostic value of new CT imaging techniques for the functional assessment of coronary artery disease: a meta-analysis. Eur Radiol 2019;29:3044-61. 
  30. Cademartiri F, Seitun S, Clemente A, et al. Myocardial blood flow quantification for evaluation of coronary artery disease by computed tomography. Cardiovasc Diagn Ther 2017;7:129-50. 
  31. Cheezum MK, Ghoshhajra B, Bittencourt MS, et al. Anomalous origin of the coronary artery arising from the opposite sinus: prevalence and outcomes in patients undergoing coronary CTA. Eur Heart J Cardiovasc Imaging 2017;18:224-35. 
  32. Warnes CA, Williams RG, Bashore TM, et al. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association task force on practice guidelines (writing committee to develop guidelines on the management of adults with congenital heart disease). Developed in collaboration with the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 2008;52:e143-263. 
  33. Dodd JD, Ferencik M, Liberthson RR, et al. Congenital anomalies of coronary artery origin in adults: 64-MDCT appearance. AJR Am J Roentgenol 2007;188:W138-46. 
  34. Canan A, Ranganath P, Goerne H, Abbara S, Landeras L, Rajiah P. CAD-RADS: pushing the limits. Radiographics 2020;40:629-52. 
  35. Diaz-Zamudio M, Bacilio-Perez U, Herrera-Zarza MC, et al. Coronary artery aneurysms and ectasia: role of coronary CT angiography. Radiographics 2009;29:1939-54.
  36. Pahlavan PS, Niroomand F. Coronary artery aneurysm: a review. Clin Cardiol 2006;29:439-43. 
  37. Flor N, Di Leo G, Squarza SA, et al. Malignant incidental extracardiac findings on cardiac CT: systematic review and meta-analysis. AJR Am J Roentgenol 2013;201:555-64.