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World J Radiol. Oct 28, 2019; 11(10): 126-133
Published online Oct 28, 2019. doi: 10.4329/wjr.v11.i10.126
Coronary artery calcium data and reporting system: Strengths and limitations
Subramaniyan Ramanathan
Subramaniyan Ramanathan, Department of Clinical Imaging, Al-Wakra Hospital, Hamad Medical Corporation, Doha 82228, Qatar
Subramaniyan Ramanathan, Department of Radiology, Weil Cornell Medical College, Qatar Foundation - Education City, Doha 24144, Qatar
Author contributions: Ramanathan S designed the outline and performed writing of the whole paper.
Conflict-of-interest statement: There is no conflict of interest associated with the author who contributed to this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Subramaniyan Ramanathan, MD, FRCR Department of Clinical Imaging, Al-Wakra Hospital, Hamad Medical Corporation, Doha 82228, Qatar. sramanathan@hamad.qa
Telephone: +974-50117935 Fax: +974-40114509
Received: May 18, 2019
Peer-review started: May 20, 2019
First decision: August 2, 2019
Revised: September 5, 2019
Accepted: September 13, 2019
Article in press: September 13, 2019
Published online: October 28, 2019
Processing time: 163 Days and 22.4 Hours
Abstract

Coronary artery calcium data and reporting system (CAC-DRS) is a recently introduced standardized reporting system for calcium scoring on computed tomography. CAC-DRS provides four risk categories (0, 1, 2 and 3) along with treatment recommendations for each category. As with any other new reporting platform, CAC-DRS has both advantages and disadvantages. Improved communication, better clarity of details, organized management recommendations and utility in future research and education are the major strengths of CAC-DRS. It has many limitations such as questionable need for a new system, few missing components, use of a less accurate visual method and treatment suggestions based on expert opinion instead of clinical trials. In this contemporary review, we discuss the new reporting system CAC-DRS, its application, strengths and limitations and conclude with some remarks for the future.

Keywords: Coronary artery calcium; Reporting system; Agatston score; Strengths; Limitations; Management

Core tip: Coronary artery calcium data and reporting system (CAC-DRS) is a new standardized reporting system for calcium scoring on computed tomography. Four CAC-DRS categories have been described ranging from CAC-DRS 0 to CAC-DRS 3 with progressively increasing cardiac disease risk. Better communication, clarity of details, clinical management recommendations, research and education are the major strengths. Few missing components, visual method, treatment recommendations and lack of clear necessity for a new reporting system are the major limitations.