2021 AHA/ACC Guideline for the Evaluation and Diagnosis of Chest Pain – CCTA has been elevated as the only Class 1 noninvasive test with Level A evidence for diagnosing and guiding treatment decisions. FFR_CT (Class 2a) provides information regarding abnormal physiology to guide coronary revascularization decisions in intermediate-to-high risk patients with identified coronary stenoses of 40-90%. Gulati, et al. JACC 2021.

2024 ESC Guidelines for the management of chronic coronary syndromes – CCTA is recommended (Class I) in those with suspected chronic coronary syndrome with low-moderate pretest likelihood of obstructive CAD or if functional imaging is not diagnostic. FFR_CT has Class I (>70% proximal LAD) and IIb (intermediate stenosis, proximal or mid coronary) recommendations. Vrints, et al. EHJ 2024.

CAD-RADS™ 2.0 – 2022 Coronary Artery Disease-Reporting and Data System – This expert consensus document updates the 2016 standardized framework for reporting CCTA results according to stenosis, plaque burden, and modifiers. It describes several methods of estimating plaque burden and adds categories P1 to P4 for increasing plaque burden. It adds modifiers for ischemia and exception, and updates the modifier for high-risk plaque. Cury, et al. JCCT 2022.

SCCT 2021 Expert Consensus Document on Coronary Computed Tomographic Angiography – This SCCT consensus statement, the first update since 2009, summarizes current evidence, recommendations, and key questions regarding contemporary use of CCTA. It reviews an extensive body of evidence regarding CCTA and formulates definitive recommendations. Narula, et al. JCCT 2021.

SCCT 2016 Guidelines for the Performance and Acquisition of Coronary Computed Tomographic Angiography – This is a report of the Society of Cardiovascular Computed Tomography Guidelines Committee endorsed by the North American Society of Cardiovascular Imaging (NASCI) to provide standards meant to ensure reliable practice methods and quality outcomes based on the best available data in order to improve the diagnostic care of patients. Abbara, et al. JCCT 2016.