ArticleEuropean radiology2026
Reporting trends and clinical impact of high-risk coronary plaques on cardiac CT angiography in CAD-RADS.
Article in European radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- High scan-rescan repeatability of AI-enabled coronary plaque quantification from coronary CT angiography.European radiology · 2026Article
- Detection of calcified plaques: comparison between coronary CT angiography and thin-slice non-contrast CT with deep learning-aided image registration.European radiology · 2026Article
- Artificial intelligence-based coronary computed tomography angiography quantification of atherosclerosis burden: comparison with intravascular ultrasound in the INVICTUS Registry.European radiology · 2026Article
- CAD-RADS: A Standardized Reporting System for Coronary CT Angiography.Journal of the Korean Society of Radiology · 2026Review
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Authors and funding
5 authors.
Funding
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Abstract
objectivesTo evaluate the reporting trends and clinical impact of the CAD-RADS modifier high-risk plaque (HRP). MATERIALS AND
methodsRadiology reports of cardiac CT angiography performed in a tertiary referral hospital between October 2017 and December 2021 were retrospectively reviewed. Cases coded with modifier HRP or with CT reports mentioning HRP were defined as "HRP-reported." The prevalence of HRP-reported cases was analyzed. Subsequent management within 90 days post-CT was reviewed for cases with suspected stable angina.
resultsAmong the 21503 cases (mean age, 62.7 years ± 12.3 [SD]; 11,127 men) enrolled, 169 cases (0.8%) were HRP-reported. HRP-reported cases were more frequent in cases with suspected acute coronary syndrome or stable angina than others (1.2% vs. 1.1% vs. 0.1%; p < 0.001), protocols for coronary CT angiography or triple-rule-out CT, compared to others (1.1% vs. 0.7% vs. 0.1%; p < 0.001), and cases with higher coronary artery calcium or CAD-RADS categories (p for trends < 0.001). HRP reporting rates varied among the readers, ranging from 0.1 to 1.3%. In the setting of suspected stable angina, the HRP-reported group more frequently underwent invasive coronary angiography in CAD-RADS 1-2 (8.8% vs. 1.4%; p = 0.01), stress testing in CAD-RADS 3 (38.5% vs. 18.4%; p = 0.02), and coronary revascularization in CAD-RADS 3 (23.1% vs. 8.7%; p = 0.02) or 4-5 (75.0% vs. 54.6%; p = 0.001).
conclusionThe CAD-RADS modifier HRP impacted the management of patients with CAD. However, its reporting prevalence was low and varied depending on the readers and clinical settings. KEY POINTS: Question Data on the real-world clinical use of CAD-RADS high-risk plaque features on cardiac CT angiography are limited. Findings The reporting prevalence of high-risk plaque was low and varied among radiologists and clinical settings in a large academic hospital. Clinical relevance This study reveals the underreporting and variability in reporting practices of high-risk plaque on cardiac CT angiography, despite its importance in managing patients with coronary artery disease.
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