Carotid Plaque-RADS Plus Ancillary Features Improves Symptomatic Plaque Detection

An integrated model combining carotid Plaque-RADS, degree of stenosis, and ancillary features (plaque burden, remodeling index, enhancement ratio, perivascular fat density) predicted symptomatic plaques with AUC 0.876 (95% CI: 0.828–0.924), and 0.919 in moderate stenosis subgrou…

• Combining Plaque-RADS with ancillary features and stenosis degree yielded an AUC of 0.876 for symptomatic plaque identification.
• In the moderate stenosis subgroup, where stenosis alone may be insufficient, the integrated model achieved AUC 0.919.
• Decision curve analysis showed the combined model provided the greatest net clinical benefit.

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