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Abstract
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Purpose Coronary calcium scores (CCSs) in cardiac-gated computed tomography (CCT) are diagnostic for coronary artery
disease (CAD). This study aims to investigate if CCSs can foretell CAD-reporting and data system (CAD-RADS) without
performing computed tomography angiography (CTA).
Methods Profiles of 544 patients were studied who had gone through CCT and CTA; the number of calcified regions of
interest (ROIs), the Agatston, area, volume, and mass CCSs were calculated. Among the CAD-RADS categories (1 to 5),
the mean values were compared for each CCS separately. A cut-off for each CCS was declared using ROC curve analysis,
more than which could predict significant CAD (CAD-RADS 3 to 5). Also, logistic regression models indicated the most
probable CAD-RADS category based on the CCSs. P < 0.05 was considered significant.
Results Among 53% male and 47% female participants with a mean (SD) age of 62.57 (0.84) years, numbers of calcified
ROIs were significantly different between each pair of CAD-RADS categories. While other CCSs did not show a significant
difference between CAD-RADS 1 and 2 or 2 and 3. All CCSs were significantly different between the non-significant and
significant CAD groups; cut-offs for the number of calcified ROIs, the Agatston, area, volume, and mass scores were 9, 128,
44mm2, 111mm3, and 22 mg, respectively. Formulae A and B predicted the most probable CAD-RADS category (accuracy:
79%) and the probability of significant/non-significant CAD (accuracy: 81%), respectively.
Conclusion CCSs could predict CAD-RADS with an accuracy of 80%. Further studies are needed to introduce more predictive calcium indices.
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