CAD-RADS™ 2.0 - 2022 Coronary Artery Disease-Reporting and Data System

Cury, Ricardo C.; Leipsic, Jonathon; Abbara, Suhny; Achenbach, Stephan; Berman, Daniel S.; Bittencourt, Márcio Sommer; Budoff, Matthew J.; Chinnaiyan, Kavitha M.; Choi, Andrew D.; Ghoshhajra, Brian; Ghoshhajra, Brian B.; Koweek, Lynne M. Hurwitz; Lesser, John R.; Maroules, Christopher D.; Rubin, Geoffrey D.; Rybicki, Frank J.; Shaw, Leslee J.; Williams, Michelle; Williamson, Eric E.; White, Charles S.; Blankstein, Ron; Villines, Todd C.

doi:10.1016/j.jcct.2022.07.002

Cited by 155 publications

(11 citation statements)

References 58 publications

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“…The prevalence of CAFs differs based on the study group, diagnostic methods, and applied definitions. To our knowledge, our report represents the largest computed tomographic study to date in adults, and the CAF prevalence of 0.11% is in line with the previous tomographic and angiographic studies [3][4][5][6][19][20][21].…”

Section: Discussionsupporting

confidence: 90%

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Computed tomographic characteristics of congenital coronary artery fistulas in an adult population

Michałowska,

Skowroński,

Michałowska

et al. 2023

Kardiol Pol

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Background: Coronary artery fistulas (CAFs) are usually congenital coronary artery anomalies of termination.Aims: This study aimed to assess the prevalence, anatomic characteristics, and clinical significance of CAFs detected by computed tomography (CT) in an adult population. Methods:We performed 45 817 CT examinations in 39 066 subjects between 2008 and 2020. The electronic database was manually checked using specific keywords to identify patients with CAFs. The CT characteristics of CAFs were evaluated. CAF was defined as clinically significant if it was the most plausible cause of myocardial infarction, infective endocarditis, heart failure, death during follow-up, hospitalization, or if it required either percutaneous or surgical intervention.Results: Of 39 066 patients, 56 CAFs were detected in 42 subjects (20 men, 47.6%) with a prevalence of 0.11%. Most CAFs originated from the right coronary artery (RCA) (48.2%) and drained into the pulmonary artery (PA) (58.9%). CAFs terminating in the PA were more frequently multiple (P <0.001) and tortuous (P <0.001) as compared to CAFs without PA drainage. Clinically significant CAFs, identified in 7 of 42 patients, were more common in younger (P = 0.03) and male (P = 0.04) subjects and had larger lumen area and diameter at the site of origin (P = 0.03, P = 0.03, respectively).Conclusions: In the unselected adult population undergoing coronary CT angiography, the RCA and the PA are the most common sites of origin and termination of CAFs, respectively. CAFs draining into the PA are more often multiple and tortuous. Clinically meaningful CAFs are larger and most frequently detected in younger and male patients.

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Section: Discussionsupporting

confidence: 90%

“…The presence and severity of atherosclerotic lesions in coronary arteries were assessed according to the Coronary Artery Disease -Reporting and Data System (CAD-RADS), which ranges from CAD-RADS 0 (no atherosclerosis) to CAD-RADS 5 (total occlusion in at least one vessel) [19].…”

Section: Methodsmentioning

confidence: 99%

Computed tomographic characteristics of congenital coronary artery fistulas in an adult population

Michałowska,

Skowroński,

Michałowska

et al. 2023

Kardiol Pol

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“…Therefore, in our classification, they are gathered under the same concept of potentially symptomatic. Unlike Rigatelli et al's 4 classification, our classification excludes the association between coronary anomalies and atherosclerotic coronary disease, due to its appropriate analysis using the CAD-RADS™ 2.0 reporting system 44 and the E modifier, making this association a separate entity, which includes the study of plaque in coronary disease and nonatherosclerotic stenosis within a single system.…”

Section: Discussionmentioning

confidence: 99%

Coronary artery anomalies: a review of the literature and a proposal for a new classification

González-Hoyos,

López-Arroyave,

Sebastián-Quiñones

et al. 2024

RCCARE

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Coronary artery anomalies (CAA) are anatomical abnormalities, usually congenital, that affect the origin, course, and termination of one of the three main epicardial coronary arteries. These may lead to adverse outcomes such as myocardial ischemia, heart failure, coronary artery disease and/or sudden death. Since their first descriptions to the present day, and thanks to the development of new technologies, more information and better characterization of these anomalies has been obtained, requiring that the original classifications be revised and updated. The aim of this article is to propose a possible new classification that combines anatomical features and the degree of clinical significance to try to achieve a better understanding, and thus facilitate the clinical choice of treatment. A narrative review was performed and cases from our experience are included.

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“…Coronary artery disease-reporting and data system (CAD-RADS) [ 31 ] aims to improve the accuracy of diagnosing and managing CAD patients. The updated 2022 CAD-RADS 2.0 classification [ 32 ] includes new elements such as plaque burden and ischemia evaluation, enabling the integration of CT-FFR or myocardial CT perfusion (CTP) data; moreover it introduces modifiers like coronary stents, high-risk plaque features, ischemia test results, and the "P" designation to classify plaque severity, based on CAC, SIS, and Visual scoring for plaque categorization [ 32 ]. Using a scale from 0 to 5, it grades coronary artery stenosis observed in CCTA images.…”

Section: Atherosclerotic Burdenmentioning

confidence: 99%

Imaging biomarkers in cardiac CT: moving beyond simple coronary anatomical assessment

Cundari,

Marchitelli,

Pambianchi

et al. 2024

Radiol med

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Cardiac computed tomography angiography (CCTA) is considered the standard non-invasive tool to rule-out obstructive coronary artery disease (CAD). Moreover, several imaging biomarkers have been developed on cardiac-CT imaging to assess global CAD severity and atherosclerotic burden, including coronary calcium scoring, the segment involvement score, segment stenosis score and the Leaman-score. Myocardial perfusion imaging enables the diagnosis of myocardial ischemia and microvascular damage, and the CT-based fractional flow reserve quantification allows to evaluate non-invasively hemodynamic impact of the coronary stenosis. The texture and density of the epicardial and perivascular adipose tissue, the hypodense plaque burden, the radiomic phenotyping of coronary plaques or the fat radiomic profile are novel CT imaging features emerging as biomarkers of inflammation and plaque instability, which may implement the risk stratification strategies. The ability to perform myocardial tissue characterization by extracellular volume fraction and radiomic features appears promising in predicting arrhythmogenic risk and cardiovascular events. New imaging biomarkers are expanding the potential of cardiac CT for phenotyping the individual profile of CAD involvement and opening new frontiers for the practice of more personalized medicine.

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CAD-RADS™ 2.0 - 2022 Coronary Artery Disease-Reporting and Data System

Cited by 155 publications

References 58 publications

Computed tomographic characteristics of congenital coronary artery fistulas in an adult population

Computed tomographic characteristics of congenital coronary artery fistulas in an adult population

Coronary artery anomalies: a review of the literature and a proposal for a new classification

Imaging biomarkers in cardiac CT: moving beyond simple coronary anatomical assessment

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