Describing the risk demonstrated on cardiac CT imaging: the C-PLUSS approach

Warrick Bishop, Matthew Budoff



The C-PLUSS approach can be used to describe the risk-related features demonstrated on cardiac CT imaging. This approach incorporates features relating to coronary calcium together with plaque and vessel specific features, which have been shown to relate to cardiovascular risk. A descriptive risk comment, as part of the cardiac CT report, can then be generated, helping the referring clinician to understand their patient’s potential future risks and so provide optimal care.

Key Points

  • Coronary calcium scoring is used predominately for risk assessment.
  • Computed coronary tomography angiography is used predominately for the assessment of stenosis.
  • Together, cardiac CT provides a snap shot of the health of the arteries.
  • Different features seen within the arteries have been shown to be associated with future risk.
  • Describing these features in combination may help future patient management.

    Picture credit: © Zephyr/SPL. Abbreviations: LAD = left anterior descending artery; RCA = right coronary artery.