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Review
. 2023 Nov 1;13(11):7621-7631.
doi: 10.21037/qims-23-603. Epub 2023 Aug 16.

The role of iodinated contrast media in computed tomography structured Reporting and Data Systems (RADS): a narrative review

Marco Parillo  1   2 , Aart J van der Molen  3 , Patrick Asbach  4 , Fabian Henry Jürgen Elsholtz  4 , Andrea Laghi  5 , Maxime Ronot  6   7 , Jim S Wu  8 , Carlo Augusto Mallio  1   2 , Carlo Cosimo Quattrocchi  9
Affiliations
Review

The role of iodinated contrast media in computed tomography structured Reporting and Data Systems (RADS): a narrative review

Marco Parillo et al. Quant Imaging Med Surg. .

Abstract

Background and objective: In recent years, there has been a large-scale dissemination of guidelines in radiology in the form of Reporting & Data Systems (RADS). The use of iodinated contrast media (ICM) has a fundamental role in enhancing the diagnostic capabilities of computed tomography (CT) but poses certain risks. The scope of the present review is to summarize the current role of ICM only in clinical reporting guidelines for CT that have adopted the "RADS" approach, focusing on three specific questions per each RADS: (I) what is the scope of the scoring system; (II) how is ICM used in the scoring system; (III) what is the impact of ICM enhancement on the scoring.

Methods: We analyzed the original articles for each of the latest versions of RADS that can be used in CT [PubMed articles between January, 2005 and March, 2023 in English and American College of Radiology (ACR) official website].

Key content and findings: We found 14 RADS suitable for use in CT out of 28 RADS described in the literature. Four RADS were validated by the ACR: Colonography-RADS (C-RADS), Liver Imaging-RADS (LI-RADS), Lung CT Screening-RADS (Lung-RADS), and Neck Imaging-RADS (NI-RADS). One RADS was validated by the ACR in collaboration with other cardiovascular scientific societies: Coronary Artery Disease-RADS 2.0 (CAD-RADS). Nine RADS were proposed by other scientific groups: Bone Tumor Imaging-RADS (BTI-RADS), Bone‑RADS, Coronary Artery Calcium Data & Reporting System (CAC-DRS), Coronavirus Disease 2019 Imaging-RADS (COVID-RADS), COVID-19-RADS (CO-RADS), Interstitial Lung Fibrosis Imaging-RADS (ILF-RADS), Lung-RADS (LU-RADS), Node-RADS, and Viral Pneumonia Imaging-RADS (VP-RADS).

Conclusions: This overview suggests that ICM is not strictly necessary for the study of bones and calcifications (CAC-DRS, BTI-RADS, Bone-RADS), lung parenchyma (Lung-RADS, LU-RADS, COVID-RADS, CO-RADS, VP-RADS and ILF-RADS), and in CT colonography (C-RADS). On the other hand, ICM plays a key role in CT angiography (CAD-RADS), in the study of liver parenchyma (LI-RADS), and in the evaluation of soft tissues and lymph nodes (NI-RADS, Node-RADS). Future studies are needed in order to evaluate the impact of the new iodinated and non-iodinate contrast media, artificial intelligence tools and dual energy CT in the assignment of RADS scores.

Keywords: Computed tomography (CT); Reporting & Data Systems (RADS); iodinated contrast media (ICM); radiology.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-23-603/coif). CAM serves as an unpaid editorial board member of Quantitative Imaging in Medicine and Surgery. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flow diagram of the search strategy and study selection. RADS, Reporting & Data Systems; ACR BI-RADS, American College of Radiology Breast Imaging-RADS; ACR C-RADS, American College of Radiology CT Colonography-RADS; ACR LI-RADS, American College of Radiology Liver Imaging-RADS; ACR Lung-RADS, American College of Radiology Lung CT Screening-RADS; ACR NI-RADS, American College of Radiology Neck Imaging-RADS; ACR O-RADS, American College of Radiology Ovarian-Adnexal Imaging RADS; ACR PI-RADS, American College of Radiology Prostate Imaging-RADS; ACR TI-RADS, American College of Radiology Thyroid Imaging-RADS; AI TI-RADS Artificial Intelligence-Thyroid Imaging-RADS; BT-RADS, Brain Tumor RADS; BTI-RADS, Bone Tumor Imaging-RADS; CAC-DRS, Coronary Artery Calcium-Data & Reporting System; CAD-RADS 2.0, Coronary Artery Disease-RADS; CO-RADS, COVID-19-RADS; COVID-RADS, Coronavirus Disease 2019 Imaging-RADS; GI-RADS, Gynecologic Imaging RADS; ILF-RADS, Interstitial Lung Fibrosis Imaging-RADS; LU-RADS, Lung RADS; MET-RADS, METastasis RADS; MY-RADS, MYeloma Response Assessment & Diagnosis System; NS-RADS, Neuropathy Score RADS; ONCO-RADS, Oncologically Relevant Findings RADS; OT-RADS, Osseous Tumor RADS; RI-RADS, Reason for exam Imaging RADS; VI-RADS, Vesical Imaging RADS; VP-RADS, Viral Pneumonia Imaging-RADS.
See this image and copyright information in PMC

References

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