The CCTA Report Just Changed
For twelve years the reference standard for reading a coronary CT was the 2014 SCCT interpretation guideline. It has now been replaced. The 2026 SCCT expert consensus on interpretation and reporting, co-chaired by Quynh Truong and Prabhakar Rajiah and written by fourteen international experts through a modified Delphi process, resets what a complete study should contain.
The central shift is that a report describing luminal stenosis alone is now incomplete. The document asks for plaque presence, composition, burden and high-risk features alongside the stenosis grade, structured through CAD-RADS 2.0, and building on the society's earlier quantitative assessment standards. It also formally accommodates what has arrived in the scanner room since 2014 — photon-counting and multi-energy CT, and AI tools for coronary segmentation, plaque quantification and artifact mitigation — and extends the expected read to stents, bypass grafts, occlusions, coronary anomalies, non-coronary cardiac findings and extra-cardiac structures.
The practical consequence is local and immediate: it is a reporting document, so the gap it exposes is between what your scanner already captures and what your template actually says. Worth noting the boundary too — the 2025 ACC scientific statement still declines to endorse routine quantitative plaque analysis or to name a plaque-volume threshold. Describe the plaque; the treatment trigger is not yet established.
Your CCTA template, not your scanner, is now the rate-limiting step.
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