CT Colonography Reporting and Data System (C-RADS): Version 2023 Update

Area of Science:

• Radiology
• Medical Imaging
• Gastroenterology

Background:

• The CT Colonography Reporting and Data System (C-RADS) is a validated classification scheme for CT colonography (CTC).
• Experience since 2005 has highlighted areas for refinement in the C-RADS scheme.
• Specific challenges include classifying mass-like appearances in diverticulitis and extracolonic findings.

Purpose of the Study:

• To update the C-RADS classification system based on accumulated experience.
• To address ambiguities in classifying mass-like diverticular strictures.
• To simplify the classification of extracolonic findings in CTC.

Main Methods:

• Review and analysis of CT colonography (CTC) findings and their classification under the C-RADS system.
• Introduction of a new subcategory (C2b) for mass-like diverticular strictures.
• Consolidation of extracolonic categories E1 and E2 into a single category (E1/E2).

Main Results:

• A new subcategory, C2b, is introduced for mass-like diverticular strictures, identified as likely benign.
• Extracolonic categories E1 (normal variant) and E2 (clinically unimportant) are combined into a single E1/E2 category.
• The updates aim to reduce confusion and streamline management recommendations.

Conclusions:

• The C-RADS 2023 update enhances the robustness of the classification system for CTC.
• The revised system improves clarity in diagnosing diverticular strictures and simplifies extracolonic finding management.
• These changes are expected to lead to more consistent and efficient patient care pathways.