European Radiology

, Volume 28, Issue 4, pp 1365–1372 | Cite as

CAD-RADS – a new clinical decision support tool for coronary computed tomography angiography

  • Borek FoldynaEmail author
  • Bálint Szilveszter
  • Jan-Erik Scholtz
  • Dahlia Banerji
  • Pál Maurovich-Horvat
  • Udo Hoffmann


Coronary computed tomography angiography (CTA) has been established as an accurate method to non-invasively assess coronary artery disease (CAD). The proposed ‘Coronary Artery Disease Reporting and Data System’ (CAD-RADS) may enable standardised reporting of the broad spectrum of coronary CTA findings related to the presence, extent and composition of coronary atherosclerosis. The CAD-RADS classification is a comprehensive tool for summarising findings on a per-patient-basis dependent on the highest-grade coronary artery lesion, ranging from CAD-RADS 0 (absence of CAD) to CAD-RADS 5 (total occlusion of a coronary artery). In addition, it provides suggestions for clinical management for each classification, including further testing and therapeutic options. Despite some limitations, CAD-RADS may facilitate improved communication between imagers and patient caregivers. As such, CAD-RADS may enable a more efficient use of coronary CTA leading to more accurate utilisation of invasive coronary angiograms. Furthermore, widespread use of CAD-RADS may facilitate registry-based research of diagnostic and prognostic aspects of CTA.

Key points

• CAD-RADS is a tool for standardising coronary CTA reports.

• CAD-RADS includes clinical treatment recommendations based on CTA findings.

• CAD-RADS has the potential to reduce variability of CTA reports.


Coronary artery disease Computed tomography angiography Coronary stenosis Classification Percutaneous coronary intervention 

Abbreviations and acronyms


Acute coronary syndrome


American HeartAssociation


Coronary artery bypass graft


Coronary artery disease


Coronary artery disease – Reporting and Data System


Computed tomography


Computed tomography angiography


Fractional flow reserve


Hounsfield units


Left anterior descending


Left main


National Institute for Health and Care Excellence


Right coronary artery


Society of Cardiovascular Computed Tomography


Thrombolysis in myocardial infarction



Borek Foldyna received funding from the German Research Foundation (DFG), project 290004377 (FO 993/1).


The authors state that this work has not received any funding.

Compliance with ethical standards


The scientific guarantor of this publication is Borek Foldyna, MD.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all three patients for the anonymised image data use.

Ethical approval

Institutional Review Board approval was not required for this special report.


Special report


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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  1. 1.Cardiac MR PET CT ProgramMassachusetts General Hospital, Harvard Medical SchoolBostonUSA
  2. 2.Department of Diagnostic and Interventional RadiologyUniversity of Leipzig – Heart CenterLeipzigGermany
  3. 3.MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular CenterSemmelweis UniversityBudapestHungary

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