Coronary CT Imaging of Atherosclerotic Plaque
Recommendations
For patients with evidence of coronary atherosclerotic plaque, it is recommended that the physician report the presence of HRP (when present) in order to improve risk stratification and guide clinical management decisions.
For patients with evidence of coronary atherosclerotic plaque, it is recommended to use the CAD-RADS modifier “V” if a coronary plaque demonstrates 2 or more HRP features in the CCTA final interpretation, or to describe what HRP characteristics are present.
For patients with evidence of coronary atherosclerotic plaque, the CT imager should consider including the SIS in the CCTA final interpretation. In patients undergoing a non-contrast scan for calcium quantification as part of their CCTA examination, it is recommended to report the total CAC score and the associated risk category of 0, 1–99, 100–299, and ≥300, respectively.
For patients with evidence of coronary atherosclerotic plaque, the conclusion of the report should include a statement regarding the overall amount or extent of atherosclerotic plaque. This can be based on a visual assessment (acknowledging the aforementioned limitations); the CAC score (if performed); or a semi-quantitative assessment of the number of coronary segments with plaque using the SIS.
Recommendation Grading
Overview
Title
Coronary CT Imaging of Atherosclerotic Plaque
Authoring Organization
Society of Cardiovascular Computed Tomography
Publication Month/Year
November 9, 2020
Last Updated Month/Year
April 1, 2024
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Male, Adult, Older adult
Health Care Settings
Ambulatory, Emergency care, Hospital
Intended Users
Physician, nurse, nurse practitioner, physician assistant
Scope
Assessment and screening, Prevention, Management
Diseases/Conditions (MeSH)
D058226 - Plaque, Atherosclerotic
Keywords
prevention, acute coronary syndrome, Atherosclerotic plaque, Prognosis, High risk plaque
Source Citation
Shaw LJ, Blankstein R, Bax JJ, Ferencik M, Bittencourt MS, Min JK, Berman DS, Leipsic J, Villines TC, Dey D, Al'Aref S, Williams MC, Lin F, Baskaran L, Litt H, Litmanovich D, Cury R, Gianni U, van den Hoogen I, R van Rosendael A, Budoff M, Chang HJ, E Hecht H, Feuchtner G, Ahmadi A, Ghoshajra BB, Newby D, Chandrashekhar YS, Narula J. Society of Cardiovascular Computed Tomography / North American Society of Cardiovascular Imaging - Expert Consensus Document on Coronary CT Imaging of Atherosclerotic Plaque. J Cardiovasc Comput Tomogr. 2021 Mar-Apr;15(2):93-109. doi: 10.1016/j.jcct.2020.11.002. Epub 2020 Nov 9. PMID: 33303383.