CAC-DRS: Coronary Artery Calcium Data and Reporting System

A calcium score is only useful if everyone reading the report understands it the same way. This SCCT consensus document tackles that unglamorous but real problem by giving coronary calcium its own standardized reporting language — CAC-DRS — modeled on the “-RADS” systems radiologists already use for mammograms and lung scans.

The framework is deliberately simple. It sorts results into four tiers (CAC-DRS 0 through 3), based on either the Agatston score or a visual estimate, and — crucially — ties each tier to a recommended action, so the number arrives at the clinician already attached to a next step. Modifiers note how many vessels are involved and whether the scan was a dedicated study or a non-gated CT. Because coronary calcium is visible on any chest CT, the system is built to extract value even from scans ordered for other reasons.

The payoff is communication and quality. A shared structure lets the radiologist, the cardiologist, and the primary doctor read the same report and reach the same conclusion, and it makes outcomes tracking and quality assurance possible across institutions.

The honest framing is that this is a reporting standard, not a clinical-evidence document. It does not establish that calcium scoring works — other statements do that — but rather how to report it once it has been done. Its evidence base is expert consensus on best practice.

We rate the evidence strong for its purpose. Standardization is the quiet infrastructure that turns a good test into a dependable one, and CAC-DRS is a well-constructed example of it.