C-RADS ™ v. 2023
References:
- Zalis ME, Barish MA, Choi JR, et al. CT colonography reporting and data system: a consensus proposal. Radiology. 2005;236(1):3-9. doi:10.1148/radiol.2361041926
- Pooler BD, Kim DH, Lam VP, Burnside ES, Pickhardt PJ. CT Colonography Reporting and Data System (C-RADS): benchmark values from a clinical screening program. AJR Am J Roentgenol. 2014;202(6):1232-1237. doi:10.2214/AJR.13.11272
- CT Colonography Reporting and Data System (C-RADS): Version 2023 Update Judy Yee, Abraham Dachman, David H. Kim, Mariya Kobi, Andrea Laghi, Elizabeth McFarland, Courtney Moreno, Seong Ho Park, Perry J. Pickhardt, Andrew Plumb, B. Dustin Pooler, Michael Zalis, and Kevin J. Chang Radiology 2024 310:1
Related Calculators:
More about the C‑RADS® 2023 Calculator:
The CT Colonography Reporting and Data System (C‑RADS®), endorsed by the American College of Radiology, is a standardized lexicon for classifying findings on CT colonography (CTC). Since its inception in 2005, C‑RADS has become a cornerstone for consistent reporting of both colonic and extracolonic discoveries. The 2023 update streamlines the system by introducing nuanced categories, enhancing the clarity and practical utility of CTC interpretation :contentReference[oaicite:1]{index=1}.
Key Updates in 2023
- New C2b Subcategory: Differentiates mass-like diverticular strictures that mimic polyps but are typically benign, reducing unnecessary colonoscopies :contentReference[oaicite:2]{index=2}.
- Extracolonic Simplification: Merges E1 and E2 into a single E1/E2 category, reflecting that neither warrants additional follow-up :contentReference[oaicite:3]{index=3}.
C‑RADS® Categories and Corresponding Actions
- C0: Incomplete or inadequate CTC—repeat recommended.
- C1: Normal colon or benign findings—return to routine screening.
- C2a: Indeterminate polyps (6–9 mm)—watchful CTC or colonoscopy follow-up.
- C2b: Likely benign mass-like strictures—targeted follow-up vs immediate colonoscopy.
- C3: Suggestive of advanced adenoma—recommend diagnostic colonoscopy.
- C4: Highly suspicious mass—urgent colonoscopy and oncology referral.
Extracolonic Findings (E‑Categories)
Findings outside the colon are classified as E1/E2 when benign or clinically unimportant, requiring no follow-up. More concerning abnormalities are categorized as E3 (likely significant) or E4 (potentially serious), which may necessitate further imaging or clinical action.
Clinical and Operational Advantages
- Enhanced Consistency: ACR-developed framework improves diagnostic clarity and reduces reporting variation :contentReference[oaicite:4]{index=4}.
- Optimized Workflow: Categorization guides targeted follow-up, minimizing unnecessary invasive procedures.
- Patient-Centered Care: Stratifies risk to avoid both over-treatment and underdiagnosis.
- Data-Driven Quality: Uniform terminology supports research, audit, and quality improvement initiatives :contentReference[oaicite:5]{index=5}.
Using the C‑RADS 2023 Calculator
The C‑RADS 2023 calculator automates categorization based on polyp size, morphology, and extracolonic findings. It provides clear, reproducible outputs that can be integrated into radiology reports and EMR systems. This leads to:
- Standardized interpretation in line with ACR‐endorsed terminology
- Automated follow-up recommendations (e.g. C2a → repeat CTC in 3 years)
- Support for multidisciplinary collaboration and patient discussions
Conclusion
The C‑RADS® 2023 update refines classification, introduces meaningful subcategories, and simplifies reporting to improve clinical value. By leveraging this tool, radiologists and clinicians can deliver evidence-based, consistent, and patient-centered colorectal screening care.
