Thursday, January 22, 2026

Coronary CT Angiography (CCTA) and the role of structured reporting in contemporary CAD management

 CCTA and Structured Reporting: Shaping Modern CAD Diagnosis


Presenter: Hasan Aydyn
Affiliation: University of Health Scıences, Turkey
Presentation Format: Oral Presentation (In-Person)

Title:
Coronary CT Angiography (CCTA) and the role of structured reporting in contemporary CAD management


🔬 Presentation Overview

🫀 Understanding Coronary CT Angiography (CCTA)

Coronary Computed Tomography Angiography (CCTA) is a non-invasive, rapid, and cost-effective cardiac imaging modality that plays a key role in the early detection, diagnosis, and risk stratification of Coronary Artery Disease (CAD). By combining CT imaging with intravenous iodine-based contrast, CCTA enables detailed visualization of coronary artery anatomy and plaque burden.

CCTA is recommended for patients presenting with acute chest pain to exclude significant obstructive CAD, as well as for intermediate- to high-risk patients with stable chest pain.

️ Imaging Technique and Patient Preparation

High-quality diagnostic imaging depends on optimizing both technical and patient-related factors. Pharmacological heart-rate control using beta-blockers is commonly employed when heart rates exceed 65 beats per minute, while nitroglycerin is administered to promote coronary vasodilation.

Patients are advised to avoid caffeine and certain medications (such as phosphodiesterase inhibitors) before the scan. Breath-holding during image acquisition is essential to minimize motion artifacts. In addition to coronary assessment, CCTA can detect extracardiac findings, including aortic pathology and pulmonary embolism.

📊 Structured Reporting with CAD-RADS 2.0

Standardized interpretation of CCTA findings is achieved using the Coronary Artery Disease–Reporting and Data System (CAD-RADS) 2.0. This structured reporting framework ensures clear communication between radiologists and cardiologists and supports consistent clinical decision-making.

CAD-RADS 2.0 categorizes coronary stenosis severity from 0 to 5 and incorporates overall plaque burden grading (P1–P4), providing a comprehensive overview of disease extent.

🧬 Key Modifiers Enhancing Risk Assessment

CAD-RADS 2.0 includes modifiers that add important prognostic and functional insights:

·         HRP (High-Risk Plaque): Applied when two or more high-risk plaque features are present, such as low-attenuation plaque, positive remodeling, spotty calcification, or the napkin-ring sign. HRP is associated with an increased risk of acute coronary syndrome, independent of stenosis severity.

·         I (Ischemia): Used when non-invasive functional assessments—such as CT-derived fractional flow reserve (CT-FFR) or stress CT perfusion (CTP)—demonstrate the hemodynamic significance of a coronary lesion, particularly in CAD-RADS 3 or 4A categories.


🩺 Clinical Impact in Modern CAD Management

CCTA offers a safe, non-invasive alternative to invasive coronary angiography (ICA), eliminating catheter-related risks and reducing recovery time. By integrating anatomical stenosis severity, plaque vulnerability, and functional significance, the CAD-RADS 2.0 framework enables radiologists to deliver actionable, clinically relevant information.

This approach supports cardiologists in selecting the most appropriate next steps—whether functional testing or ICA—especially in patients with moderate to severe coronary stenosis (CAD-RADS 4A/4B).


📅 Conference Details

Event: International Conference on Cardiology and Cardiovascular Science
Dates: March 26–28, 2026
Venue: Singapore & Online
Website:
https://cardiology.miconferences.com/

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