Quantitative Coronary Plaque Analysis in Clinical Practice: 2025 ACC Scientific Statement: A Report of the American College of Cardiology

Technological advances in coronary computed tomography angiography and artificial intelligence have resulted in an increasing capability to analyze and quantify information about atherosclerotic coronary plaque through noninvasive imaging. This has paved the way for a growing number of U.S. Food and Drug Administration-cleared products that can perform quantitative coronary plaque analysis (QCPA). To date, research has focused on the accuracy, prognostic value, and decision-making impact of QCPA, but there is no current consensus on its appropriate use in clinical practice. To address this gap, the American College of Cardiology convened a panel of experts for a 1-day symposium to discuss key questions related to the use of QCPA in clinical practice and develop consensus recommendations to guide cardiovascular clinicians and imagers on the use of QCPA. This scientific statement provides guidance on clinical indications (including possible uses of QCPA in serial imaging), methods for interpretation and reporting, and standardization. Future research directions are also addressed, including both the collection of ongoing registry data and potential for incorporation of QCPA into outcomes trials.

Published by JACC. Cardiovascular imaging, 2026. The guideline itself is at the source linked here.

doi.org/10.1016/j.jcmg.2025.11.008