4.4 Article

CAD-RADSTM 2.0-2022 Coronary Artery Disease-Reporting and Data System An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT), the American College of Cardiology (ACC), the American College of Radiology (ACR), and the North America Society of Cardiovascular Imaging (NASCI)

Journal

JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY
Volume 16, Issue 6, Pages 536-557

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.jcct.2022.07.002

Keywords

Coronary artery disease; Coronary CTA; CAD -RADS; Reporting and data system; Stenosis severity; Report standardization terminology; Plaque burden; Ischemia

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Coronary Artery Disease Reporting and Data System (CAD-RADS) is a standardized reporting system for patients undergoing coronary CT angiography (CCTA), aiming to guide patient management. The updated CAD-RADS 2.0 improves the initial reporting system for CCTA by considering new technical developments and clinical guidelines, including the assessment of stenosis, plaque burden, and modifiers.
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 indi-cating 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

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