Comparison of prognostic value between CAD-RADS 1.0 and CAD-RADS 2.0 evaluated by convolutional neural networks based CCTA

Zengfa Huang; Yang Yang; Zheng Wang; Yunting Hu; Beibei Cao; Mei Li; Xinyu Du; Xi Wang; Zuoqin Li; Wanpeng Wang; Yi Ding; Jianwei Xiao; Yun Hu; Xiang Wang

doi:10.1016/j.heliyon.2023.e15988

Comparison of prognostic value between CAD-RADS 1.0 and CAD-RADS 2.0 evaluated by convolutional neural networks based CCTA

Heliyon. 2023 May 4;9(5):e15988. doi: 10.1016/j.heliyon.2023.e15988. eCollection 2023 May.

Authors

Zengfa Huang¹, Yang Yang¹, Zheng Wang¹, Yunting Hu¹, Beibei Cao², Mei Li², Xinyu Du¹, Xi Wang¹, Zuoqin Li¹, Wanpeng Wang¹, Yi Ding¹, Jianwei Xiao¹, Yun Hu¹, Xiang Wang¹

Affiliations

¹ Department of Radiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430014, China.
² Department of Community Health, Hanyang District Center For Disease Control and Prevention, Wuhan, Hubei, 430050, China.

Abstract

Objectives: The aim of the present study was to investigate the prognostic value of the novel coronary artery disease reporting and data system (CAD-RADS) 2.0 compared with CAD-RADS 1.0 in patients with suspectedcoronary artery disease (CAD) evaluated by convolutional neural networks (CNN) based coronary computed tomography angiography (CCTA).

Methods: A total of 1796 consecutive inpatients with suspected CAD were evaluated by CCTA for CAD-RADS 1.0 and CAD-RADS 2.0 classifications. Kaplan-Meier and multivariate Cox models were used to estimate major adverse cardiovascular events (MACE) inclusive of all-cause mortality or myocardial infarction (MI). The C-statistic was used to assess the discriminatory ability of the two classifications.

Results: In total, 94 (5.2%) MACE occurred over the median follow-up of 45.25 months (interquartile range 43.53-46.63 months). The annualized MACE rate was 0.014 (95% CI: 0.011-0.017). Kaplan-Meier survival curves indicated that the CAD-RADS classification, segment involvement score (SIS) grade, and Computed Tomography Fractional Flow Reserve (CT-FFR) classification were all significantly associated with the increase in the cumulative MACE (all P < 0.001). CAD-RADS classification, SIS grade, and CT-FFR classification were significantly associated with endpoint in univariate and multivariate Cox analysis. CAD-RADS 2.0 showed a further incremental increase in the prognostic value in predicting MACE (c-statistic 0.702, 95% CI: 0.641-0.763, P = 0.047), compared with CAD-RADS 1.0.

Conclusions: The novel CAD-RADS 2.0 evaluated by CNN-based CCTA showed higher prognostic value of MACE than CAD-RADS 1.0 in patients with suspected CAD.

Keywords: CAD-RADS; Coronary artery disease; Coronary computed tomography angiography; Prognosis.