CAD-RADS™ 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)

Ricardo C. Cury, Miami Cardiac and Vascular Institute and Baptist Health of South Florida, 8900 N Kendall Drive, Miami FL, 33176, USA. Electronic address: rcury@baptisthealth.net.
Ron Blankstein, Brigham and Women's Hospital, Harvard Medical School, USA. Electronic address: rblankstein@bwh.harvard.edu.
Jonathon Leipsic, Department of Radiology | University of British Columbia, USA. Electronic address: jleipsic@providencehealth.bc.ca.
Suhny Abbara, Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA. Electronic address: Suhny.Abbara@UTSouthwestern.edu.
Stephan Achenbach, Friedrich-Alexander-Universität, Department of Cardiology, Ulmenweg 18, 90154, Erlangen, Germany. Electronic address: Stephan.Achenbach@uk-erlangen.de.
Daniel Berman, Cedars-Sinai Medical Center, USA. Electronic address: bermand@cshs.org.
Marcio Bittencourt, Division of Cardiology, University of Pittsburgh, USA. Electronic address: bittencourtms@upmc.edu.
Matthew Budoff, David Geffen School of Medicine, UCLA, USA. Electronic address: mbudoff@labiomed.org.
Kavitha Chinnaiyan, Beaumont Hospital, Royal Oak, MI, USA. Electronic address: kchinnaiyan@beaumont.edu.
Andrew D. Choi, The George Washington University School of Medicine, USA. Electronic address: adchoi@gwu.edu.
Brian Ghoshhajra, Department of Radiology, Massachusetts General Hospital, USA. Electronic address: bghoshhajra@mgh.harvard.edu.
Jill Jacobs, NYU Langone Medical Center, 550 First Avenue, New York, NY, 10016, USA. Electronic address: jill.jacobs@nyumc.org.
Lynne Koweek, Department of Radiology Duke University, USA. Electronic address: lynne.koweek@duke.edu.
John Lesser, Division of Cardiology, Minneapolis Heart Institute, USA. Electronic address: jrlesser1@gmail.com.
Christopher Maroules, Naval Medical Center Department of Radiology, USA. Electronic address: christopher.maroules@gmail.com.
Geoffrey D. Rubin, Department of Medical Imaging, University of Arizona, USA. Electronic address: grubin@arizona.edu.
Frank J. Rybicki, Department of Radiology, University of Cincinnati College of Medicine, USA. Electronic address: rybickfk@ucmail.uc.edu.
Leslee J. Shaw, Icahn School of Medicine at Mount Sinai, USA. Electronic address: leslee.shaw@mountsinai.org.
Michelle C. Williams, University of Edinburgh, USA. Electronic address: michelle.williams@ed.ac.uk.
Eric Williamson, Department of Radiology Mayo Clinic, USA. Electronic address: ewilliamson@mayo.edu.
Charles S. White, University of Maryland, USA. Electronic address: cwhite@umm.edu.
Todd C. Villines, Division of Cardiology, University of Virginia Health System, USA. Electronic address: tv4bc@virginia.edu.

Document Type

Journal Article

Publication Date

7-8-2022

Journal

Journal of cardiovascular computed tomography

DOI

10.1016/j.jcct.2022.07.002

Keywords

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

Abstract

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.

Department

Medicine

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