Coronary Artery Calcium Data and Reporting System
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CAC-DRS (CoronaryCoronary Artery Calcium Data and Reporting System (CAC-DRS) is a structured reporting scheme for all non-contrast CT scans in the evaluation of coronary artery disease, which can help in communication between clinicians and radiologists. This document hasThese guidelines have been recommended by the SCCT (SocietySociety of Cardiovascular Computed Tomography) and STR (SocietySociety of Thoracic Radiology) Guideline 1.
This system will apply to all dedicated CACcoronary artery calcium (CAC) scans and all nongated non-contrast chest CT. Radiologists can interpret both visually and quantitatively with the Agatston score.
Interpretation categories and management recommendations.
Agatston Score (A)
CAC-DRS A0:
- CAC
Scorescore = 0 -
Veryvery low risk -
Statinstatin generally not recommended (excluding familial hypercholesterolemia).
CAC-DRS A1:
- CAC
Scorescore = 1–99 -
Mildlymildly increased risk. -
Moderate intensitymoderate-intensity statin.
CAC-DRS A2:
- CAC
Scorescore = 100–299 -
Moderatelymoderately increased risk. -
Moderatemoderate to high-intensity statin +ASA (acetylsalicylicacetylsalicylic acid (ASA) 81mg.
CAC-DRS A3:
- CAC
Scorescore > 300 -
Moderatelymoderately to severely increased risk. -
Highhigh intensity statin + ASA(acetylsalicylic acid)81mg.
Visual Score (V)
The visual score may be utilized for non-contrast non-gated studies but should not be applied to gated CAC scans.
CAC-DRS V0:
- CAC
Visual Scorevisual score = 0 -
Veryvery low risk -
Statinstatin generally not recommended (excluding familial hypercholesterolemia).
CAC-DRS V1:
- CAC
Visual Scorevisual score = 1 -
Mildlymildly increased risk. -
Moderate intensitymoderate-intensity statin.
CAC-DRS V2:
- CAC
Visual Scorevisual score = 2 -
Moderatelymoderately increased risk. -
Moderatemoderate to high-intensity statin + ASA(acetylsalicylic acid) 81mg.81mg
CAC-DRS V3:
- CAC
Visual Scorevisual score = 3 -
Moderatelymoderately to severely increased risk. -
Highhigh intensity statin + ASA(acetylsalicylic acid) 81mg.81mg
Example reports.
By comparison, the Agatston score in this scale uses a different grading of calcification (1-300), as well as an additional modifier (N). Additional modifier (N) is used to characterize the number of affected coronary arteries.
Agatston Score (A)
- CAC-DRS A0: CAC 0
- CAC-DRS A1/N3: CAC 1–99 in LM, LAD and LCx
- CAC-DRS A2/N3: CAC 100–299 in LAD, LCX and RCA
- CAC-DRS A3/N4: CAC > 300 in LM, LAD, LCx and RCA
Visual Score (V)
- CAC-DRS V0: CAC 0
- CAC-DRS V1/N3: CAC 1 in LM, LAD and LCx
- CAC-DRS V2/N3: CAC 2 in LAD, LCX and RCA
- CAC-DRS V3/N4: CAC 3 in LM, LAD, LCx and RCA
Incidental findings in CAC-DRS reports.
-
Pericardium (for examplepericardium, e.g. pericardium effusion, pericarditis) -
Ascendingascending aorta(normal, e.g. normal less than 4 cm) -
Descendingdescending aorta(normal, e.g. normal less than 3 cm) -
Pulmonarypulmonary trunk(normal, e.g.normal less than 29 mm) -
Extraextra-coronary calcification(aortic, e.g. aortic valve or wall calcification, mitral valve calcification) -
Otherother findings(, e.g. lung nodule).
See also
-<p><strong>CAC-DRS (Coronary Artery Calcium Data and Reporting System)</strong> is a structured reporting scheme for all non-contrast CT scans in the evaluation of <a href="/articles/coronaryartery-disease">coronary artery disease</a>, which can help in communication between clinicians and radiologists. This document has been recommended by the SCCT (Society of Cardiovascular Computed Tomography) and STR (Society of Thoracic Radiology) Guideline <sup>1</sup>.</p><p>This system will apply to all dedicated CAC scans and all nongated non-contrast chest CT. Radiologists can interpret both visually and quantitatively with <a href="/articles/agatston-score">Agatston score</a>.</p><h4>Interpretation categories and management recommendations.</h4><h5>Agatston Score (A)</h5><p><strong>CAC-DRS A0:</strong></p><ul>-<li>CAC Score = 0 </li>-<li>Very low risk</li>-<li>Statin generally not recommended (excluding familial hypercholesterolemia).</li>-</ul><p><strong>CAC-DRS A1: </strong></p><ul>-<li>CAC Score = 1–99</li>-<li>Mildly increased risk. </li>-<li>Moderate intensity statin.</li>-</ul><p><strong>CAC-DRS A2:</strong> </p><ul>-<li>CAC Score = 100–299</li>-<li>Moderately increased risk. </li>-<li>Moderate to high-intensity statin + ASA (acetylsalicylic acid) 81mg. </li>-</ul><p><strong>CAC-DRS A3:</strong> </p><ul>-<li>CAC Score > 300 </li>-<li>Moderately to severely increased risk. </li>-<li>High intensity statin + ASA (acetylsalicylic acid) 81mg. </li>-</ul><h5>Visual Score (V)</h5><p>The visual score may be utilized for non-contrast non-gated studies but should not be applied to gated CAC scans.</p><p><strong>CAC-DRS V0:</strong></p><ul>-<li>CAC Visual Score = 0 </li>-<li>Very low risk </li>-<li>Statin generally not recommended (excluding familial hypercholesterolemia).</li>-</ul><p><strong>CAC-DRS V1: </strong></p><ul>-<li>CAC Visual Score = 1</li>-<li>Mildly increased risk. </li>-<li>Moderate intensity statin.</li>- +<p><strong>Coronary Artery Calcium Data and Reporting System (CAC-DRS)</strong> is a structured reporting scheme for all non-contrast CT scans in the evaluation of <a href="/articles/coronaryartery-disease">coronary artery disease</a>, which can help in communication between clinicians and radiologists. These guidelines have been recommended by the Society of Cardiovascular Computed Tomography and Society of Thoracic Radiology <sup>1</sup>.</p><p>This system will apply to all dedicated <a title="Coronary artery calcium" href="/articles/coronary-artery-calcification">coronary artery calcium</a> (CAC) scans and all nongated non-contrast chest CT. Radiologists can interpret both visually and quantitatively with the <a href="/articles/agatston-score">Agatston score</a>.</p><h4>Interpretation categories and management recommendations</h4><h5>Agatston Score (A)</h5><p><strong>CAC-DRS A0</strong></p><ul>
- +<li>CAC score = 0 </li>
- +<li>very low risk</li>
- +<li>statin generally not recommended (excluding familial hypercholesterolemia).</li>
- +</ul><p><strong>CAC-DRS A1:</strong></p><ul>
- +<li>CAC score = 1–99</li>
- +<li>mildly increased risk</li>
- +<li>moderate-intensity statin</li>
- +</ul><p><strong>CAC-DRS A2</strong></p><ul>
- +<li>CAC score = 100–299</li>
- +<li>moderately increased risk</li>
- +<li>moderate to high-intensity statin + acetylsalicylic acid (ASA) 81mg</li>
- +</ul><p><strong>CAC-DRS A3</strong></p><ul>
- +<li>CAC score > 300 </li>
- +<li>moderately to severely increased risk</li>
- +<li>high intensity statin + ASA 81mg</li>
- +</ul><h5>Visual Score (V)</h5><p>The visual score may be utilized for non-contrast non-gated studies but should not be applied to gated CAC scans.</p><p><strong>CAC-DRS V0</strong></p><ul>
- +<li>CAC visual score = 0 </li>
- +<li>very low risk </li>
- +<li>statin generally not recommended (excluding familial hypercholesterolemia)</li>
- +</ul><p><strong>CAC-DRS V1</strong></p><ul>
- +<li>CAC visual score = 1</li>
- +<li>mildly increased risk</li>
- +<li>moderate-intensity statin</li>
-<li>CAC Visual Score = 2</li>-<li>Moderately increased risk. </li>-<li>Moderate to high-intensity statin + ASA (acetylsalicylic acid) 81mg. </li>- +<li>CAC visual score = 2</li>
- +<li>moderately increased risk</li>
- +<li>moderate to high-intensity statin + ASA 81mg</li>
-<li>CAC Visual Score = 3</li>-<li>Moderately to severely increased risk. </li>-<li>High intensity statin + ASA (acetylsalicylic acid) 81mg. </li>-</ul><h4>Example reports.</h4><p>By comparison the Agatston score in this scale uses a different grading of calcification (1-300), as well as an additional modifier (N). Additional modifier (N) is used to characterize the number of affected coronary arteries. </p><h6>Agatston Score (A)</h6><ul>- +<li>CAC visual score = 3</li>
- +<li>moderately to severely increased risk</li>
- +<li>high intensity statin + ASA 81mg</li>
- +</ul><h4>Example reports</h4><p>By comparison, the Agatston score in this scale uses a different grading of calcification (1-300), as well as an additional modifier (N). Additional modifier (N) is used to characterize the number of affected coronary arteries. </p><h6>Agatston Score (A)</h6><ul>
-</ul><h4>Incidental findings in <strong>CAC-DRS</strong> reports.</h4><ul>-<li>Pericardium (for example <a href="/articles/pericardium-effusion">pericardium effusion</a>, <a href="/articles/pericarditis">pericarditis</a>)</li>-<li>Ascending aorta (normal less than <a href="/articles/ascending-aorta-dilatation">4 cm</a>)</li>-<li>Descending aorta (normal less than 3 cm)</li>-<li>Pulmonary trunk (normal less than <a href="/articles//pulmonary-trunk">29 mm)</a>- +</ul><h4>Incidental findings in <strong>CAC-DRS</strong> reports</h4><ul>
- +<li>pericardium, e.g. <a href="/articles/pericardium-effusion">pericardium effusion</a>, <a href="/articles/pericarditis">pericarditis</a>
- +</li>
- +<li>ascending aorta, e.g. normal less than 4 cm</li>
- +<li>descending aorta, e.g. normal less than 3 cm</li>
- +<li>pulmonary trunk, e.g.normal less than 29 mm</li>
- +<li>extra-coronary calcification, e.g. aortic valve or wall calcification, <a href="/articles/mitral-valve-calcification">mitral valve calcification</a>
- +</li>
- +<li>other findings, e.g. <a href="/articles/pulmonary-nodule">lung nodule</a>
-<li>Extra-coronary calcification (aortic valve or wall calcification, <a href="/articles/mitral-valve-calcification">mitral valve calcification</a>)</li>-<li>Other findings (<a href="/articles/pulmonary-nodule">lung nodule</a>). </li>
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