CCTA vs CAC scan to detect atherogenic plaque

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mcs

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Has anyone done a CAC scan and CCTA and observed a wide difference in results?

My recent CCTA (coronary computed tomography angiography; see below) showed "no evidence of coronary atherosclerotic plaques or coronary artery stenosis". This is in direct contrast to the CAC scan I had done in 2021 (see below) and that I posted on here before which makes me question the accuracy of that scan which reflected a Agatston score of 28. Then again, we are dealing with 2 different methodologies done 18 months apart.

CCTAs are more accurate and comprehensive than a CAC scan, but are more costly, emit a bit more radiation, and are done with a contrast agent. The test was performed with a Canon 256-slice scanner.

My latest CCTA didn't include calcium scoring (it's an add on and only by request), but the radiologist stated that my CCTA was clear and doing an additional calcium score would not be beneficial.

CCTA - 02-17-23
CAC - 09-23-21

Thoughts?
 
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