Carotid Plaque-RADS: A Novel Stroke Risk Classification System

Area of Science:

• Vascular Medicine
• Radiology
• Neurology

Background:

• Carotid artery atherosclerosis is a significant risk factor for ischemic stroke.
• Current reporting of carotid plaque features lacks consensus, hindering consistent interpretation.
• Vulnerable plaque morphology is recognized but not uniformly reported.

Purpose of the Study:

• To introduce the Plaque-RADS (Reporting and Data System) score for standardized carotid plaque imaging and reporting.
• To establish a consistent and comprehensive approach for evaluating carotid plaque characteristics.
• To develop a universal classification system for carotid plaque and its defining features.

Main Methods:

• A panel of experts developed the Plaque-RADS categories through consensus.
• Multimodality imaging analysis was employed to define plaque characteristics.
• Existing published reports informed the development of the classification system.

Main Results:

• The Plaque-RADS score provides a morphological assessment alongside stenosis quantification.
• The score ranges from grade 1 (no plaque) to grade 4 (complicated plaque).
• Visual examples are provided to clarify Plaque-RADS categories for researchers and clinicians.

Conclusions:

• Plaque-RADS offers a standardized and reliable method for reporting carotid plaque using various imaging modalities (ultrasound, CT, MRI).
• This scoring system can improve patient care by identifying individuals who may benefit from specific medical interventions.
• Structured reporting and a standardized lexicon enhance communication among healthcare professionals and researchers.