In Journal of the American College of Radiology : JACR
Coronary Artery Disease Reporting and Data System (CAD-RADS) was created to standardize reporting system for patients undergoing coronary CT angiography (CCTA) and to guide possible next steps in patient management. The goal of this updated 2022 CAD-RADS 2.0 is to improve the initial reporting system for CCTA by considering new technical developments in Cardiac CT, including data from recent clinical trials and new clinical guidelines. The updated CAD-RADS classification will follow an established framework of stenosis, plaque burden, and modifiers, which will include assessment of lesion-specific ischemia using CT fractional-flow-reserve (CT-FFR) or myocardial CT perfusion (CTP), when performed. Similar to the method used in the original CAD-RADS version, the determinant for stenosis severity classification will be the most severe coronary artery luminal stenosis on a per-patient basis, ranging from CAD-RADS 0 (zero) for absence of any plaque or stenosis to CAD-RADS 5 indicating the presence of at least one totally occluded coronary artery. Given the increasing data supporting the prognostic relevance of coronary plaque burden, this document will provide various methods to estimate and report total plaque burden. The addition of P1 to P4 descriptors are used to denote increasing categories of plaque burden. The main goal of CAD-RADS, which should always be interpreted together with the impression found in the report, remains to facilitate communication of test results with referring physicians along with suggestions for subsequent patient management. In addition, CAD-RADS will continue to provide a framework of standardization that may benefit education, research, peer-review, artificial intelligence development, clinical trial design, population health and quality assurance with the ultimate goal of improving patient care.
Cury Ricardo C, Leipsic Jonathon, Abbara Suhny, Achenbach Stephan, Berman Daniel, Bittencourt Marcio, Budoff Matthew, Chinnaiyan Kavitha, Choi Andrew D, Ghoshhajra Brian, Jacobs Jill, Koweek Lynne, Lesser John, Maroules Christopher, Rubin Geoffrey D, Rybicki Frank J, Shaw Leslee J, Williams Michelle C, Williamson Eric, White Charles S, Villines Todd C, Blankstein Ron
2022-Nov
CAD-RADS, Coronary CTA, Coronary artery disease, Ischemia, Plaque burden, Report standardization terminology, Reporting and data system, Stenosis severity
