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CAD-RADS 2.0

Clinical Presentation

Stable chest pain

Acute chest pain

Stenosis

No plague, stenosis
<25% stenosis
25%-49% stenosis
50%-69% stenosis (other than LM)

Left main ≥50% stenosis or 3-vessel disease (>70%)
70%-99% stenosis
Total occlusion
Non-diagnostic (due to motion or other artifacts)

Stent present Bypass graft present

Non-evaluable segment present (i.e. cannot exclude obstructive CAD due to motion or other artifacts)

High Risk Plaque

No
Yes

HRP; two or more of the following features in the same plaque:

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

Any non-atherosclerotic abnormality of coronary arteries?

No
Yes

Non-atherosclerotic causes of coronary abnormalities:

- Coronary dissection
- Anomalous origin
- Aneurysm or pseudoaneurysm
- Vasculitis
- Coronary artery fistula
- Extrinsic compression
- AV malformation

Ischemia

CT-FFR / CTP not performed
CT-FFR >0.80 / No stress inducible perfusion defect
CT-FFR ≤0.75 / Stress inducible perfusion defect
CT-FFR 0.76-0.80 / Borderline CTP