CAD-RADS Calculator (v. 2.0 = 2022)

Coronary Artery Disease - Reporting and Data System (CAD RADS ™), updated in 2022

CAD-RADS (NEW)

What is the patient's status?

Acute chest pain

Stable chest pain

Are there any vessels that cannot be evaluated due to motion or other artifacts (i.e. cannot exclude obstructive CAD)?

Yes

No

Does the patient have atherosclerotic plaques?

Yes

No

Does any of the following apply?

There is three vessel disease

Left main stenosis is ≥ 50%

Both apply (3VD and L main ≥ 50%)

Neither apply

How severe is the plague burden?

P1: Mild * (1-2 vessels with mild amount of plaque)

P2: Moderate † (1 -2 vessels with moderate amount; 3 vessels with mild amount of plaque)

P3: Severe § (3 vessels with moderate amount; 1 vessel with severe amount of plaque)

P4: Extensive amount ¶ (2-3 vessels with severe amount of plaque)

* P1 = CAC 1-100, or SIS ≤2
† P2 = CAC 101-300, or SIS 3-4
§ P3 = CAC 301-999, or SIS 5-7
¶ P4 = CAC >1000, or SIS ≥ 8

Does the patient have high risk atherosclerotic plaques † (HRP)?

Yes

No

† High-risk plaques have two or more high risk features which include:

Spotty calcifications
Low attenuation plaque (less than 30 Hounsfield Units)
Positive remodeling
“Napkin ring" sign

Does the patient have any stents?

Yes

No

Does the patient have any grafts?

Yes

No

Does the patient have any non-atherosclerotic causes of coronary abnormalities*?

Yes

No

* Non-atherosclerotic causes of coronary abnormalities such as: Coronary dissection, Anomalous origin of the coronary arteries, Coronary artery aneurysm or pseudoaneurysm, Vasculitis, Coronary artery fistula, Extrinsic coronary artery compression, and Arterio-venous malformation

Are either CT-FFR or CCTA available?

CT-FFR

CCTA

Neither are available

How are the results of CT-FFR?

Normal (> 0.80)

Abnormal (≤ 0.75)

Borderline (0.76 - 0.80)

How are the results of the CCTA?

No ischemia

Presence of a prior fixed myocardial infarct

Myocardial ischemia (reversible perfusion defect)

Peri-infarct ischemia (perfusion defect during stress larger than rest perfusion defect)

Reference:

Cury, Ricardo C et al. “CAD-RADS™ 2.0 - 2022 Coronary Artery Disease-Reporting and Data System: An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT), the American College of Cardiology (ACC), the American College of Radiology (ACR), and the North America Society of Cardiovascular Imaging (NASCI).” JACC. Cardiovascular imaging, S1936-878X(22)00401-6. 9 Sep. 2022, doi:10.1016/j.jcmg.2022.07.002

Related Calculators:

Lung-RADS 2022

Based on the most recent updates by the ACR

fleischner guideline calculator incidental nodules

Incidental Pulmonary Nodule Calculator

Based on guidelines of the Fleischner society

More about the CAD-RADS calculator:

Initially published in 2016, the Coronary Artery Disease Reporting and Data System (CAD-RADS ™) is a standardized reporting system for coronary CT angiography developed by the Society for Cardiovascular Computed Tomography (SCCT), the American College of Radiology (ACR), and the North American Society for Cardiovascular Imaging (NASCI), which has also been endorsed by the American College of Cardiology (ACC).