Coronary Artery Disease Reporting and Data System
CAD-RADS is the standardized way radiologists report coronary CT angiography and translate what they see into a management recommendation. A single per-patient category from 0 to 5 is driven by the most severe coronary stenosis, so a report means the same thing to the cardiologist reading it. Version 2.0 broadened the system beyond stenosis alone: it adds plaque-burden scoring (P1–P4), renames “vulnerable plaque” as high-risk plaque, introduces an ischemia modifier for CT-FFR and stress CT perfusion, and splits severe disease into 4A and 4B to sharpen the referral pathway. It is jointly maintained by the cardiac-imaging societies and is the dominant coronary-CTA reporting standard in the US and internationally.
Broadened the system beyond stenosis alone: adds plaque-burden scoring (P1–P4), renames vulnerable plaque as high-risk plaque, introduces an ischemia modifier for CT-FFR and stress CT perfusion, and splits severe disease into 4A and 4B to sharpen the referral pathway.
The original release: established a single per-patient 0–5 category driven by the most severe coronary stenosis, standardizing coronary-CTA reporting and tying each category to a management recommendation.
In 221 patients undergoing cardiac CT/CTA, epicardial adipose tissue volume (EAV) independently associated with CAD after adjusting for traditional risk factors and calcium score; extensive plaque burden rose from 15.6% to 46.7% across EAV quartiles. EAV did not predict high-ris…
Claude 3.7 achieved almost perfect CAD-RADS agreement (κ=0.997) on synthetic CCTA reports, but all LLMs struggled with high-grade stenosis (4A/4B) and management recommendations. Performance varied by prompt identity (radiologist vs cardiologist).
RadPigeon is an independent radiology news digest and is not affiliated with or endorsed by SCCT, ACC, ACR & NASCI (multi-society). “CAD-RADS” is a trademark of its owner and is named here only to refer to the system. Always consult the official source for the exact, current criteria.
