Coronary CT Imaging of Atherosclerotic Plaque

The interpreting physician should include integrate evidence of coronary artherosclerotic plaque into the laboratory standard report.

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.