Society of Cardiovascular Computed Tomography / North American Society of Cardiovascular Imaging – Expert consensus document on coronary CT imaging of atherosclerotic plaque

Leslee J. Shaw, Ron Blankstein, Jeroen J. Bax, Maros Ferencik, Marcio Sommer Bittencourt, James K. Min, Daniel S. Berman, Jonathon Leipsic, Todd C. Villines, Damini Dey, Subhi Al'Aref, Michelle C. Williams, Fay Lin, Lohendran Baskaran, Harold Litt, Diana Litmanovich, Ricardo Cury, Umberto Gianni, Inge van den Hoogen, Alexander R. van RosendaelMatthew Budoff, Hyuk Jae Chang, Harvey E. Hecht, Gudrun Feuchtner, Amir Ahmadi, Brian B. Ghoshajra, David Newby, Y. S. Chandrashekhar, Jagat Narula

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Coronary computed tomographic angiography (CCTA) provides a wealth of clinically meaningful information beyond anatomic stenosis alone, including the presence or absence of nonobstructive atherosclerosis and high-risk plaque features as precursors for incident coronary events. There is, however, no uniform agreement on how to identify and quantify these features or their use in evidence-based clinical decision-making. This statement from the Society of Cardiovascular Computed Tomography and North American Society of Cardiovascular Imaging addresses this gap and provides a comprehensive review of the available evidence on imaging of coronary atherosclerosis. In this statement, we provide standardized definitions for high-risk plaque (HRP) features and distill the evidence on the effectiveness of risk stratification into usable practice points. This statement outlines how this information should be communicated to referring physicians and patients by identifying critical elements to include in a structured CCTA report - the presence and severity of atherosclerotic plaque (descriptive statements, CAD-RADS™ categories), the segment involvement score, HRP features (e.g., low attenuation plaque, positive remodeling), and the coronary artery calcium score (when performed). Rigorous documentation of atherosclerosis on CCTA provides a vital opportunity to make recommendations for preventive care and to initiate and guide an effective care strategy for at-risk patients.

    Original languageEnglish (US)
    JournalJournal of Cardiovascular Computed Tomography
    DOIs
    StateAccepted/In press - 2020

    Keywords

    • Acute coronary syndrome
    • Atherosclerotic plaque
    • High risk plaque
    • Prevention
    • Prognosis

    ASJC Scopus subject areas

    • Radiology Nuclear Medicine and imaging
    • Cardiology and Cardiovascular Medicine

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