A new expert consensus document reviews the available evidence on coronary CT angiography (CCTA) of atherosclerotic plaque.
The document is a collaborative effort from the Society of Cardiovascular Computed Tomography (SCCT) and the North American Society of Cardiovascular Imaging (NASCI). The expert guidance was jointly published in both the Journal of Cardiovascular Computed Tomography and the International Journal of Cardiovascular Imaging.
The new document reviews the evidence and provides a consensus summary and recommendations regarding CCTA imaging of atherosclerotic plaque. It also standardizes the definitions for high-risk plaque features and provides practice points related to risk stratification.
In addition, the document highlights evidence gaps in plaque imaging and future research needs. It also provides minimum data elements for structured reporting.
![Axial images from unenhanced calcium score cardiac CT (left) and curved planar reformation images from CT angiography (right) show that higher long-term exposure to air pollution is associated with greater coronary artery calcium and more obstructive coronary artery disease (CAD). Top row: Images in a 68-year-old male patient with higher 10-year mean ambient air pollution exposure (7.9 μg/m3 for particulate matter measuring ≤2.5 μm in diameter [PM2.5] and 17.4 parts per billion [ppb] for NO2) with extensive CAD (coronary artery calcium score [CACS] >1,000 and obstructive CAD [≥70% diameter stenosis]). Bottom row: Images in a 57-year-old female patient with lower 10-year mean ambient air pollution exposure (6.3 μg/m3 for PM2.5 and 4.6 ppb for NO2) with no CAD (CACS = 0 and no obstructive stenosis).](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/06/hanneman.r6SMLzkezo.png?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
