We’ve got answers.
Straight answers from Q, MD & Claudia · updated 2026-11-10
Claudia · Not my job
Nope. I never open DICOM files or connect to your PACS. You read the study, you mark what you see, and I apply the published CAD-RADS 2.0 rules to what you marked and draft the report. If you don't mark it, it doesn't exist for me.
Q, MD · Not my job
It's not a medical device, and it doesn't replace your clinical judgment. What you get is an editable draft: you check it against the study, change what needs changing, and finalize and sign it outside the tool, under your own responsibility. The tool only organizes what you told it.
Claudia · Explains
It's free, with no sign-up and no account: open the page and start marking. It's built for cardiovascular imaging professionals, and for trainees working under supervision. It's available in 15 languages, and it's not meant for patients or for self-diagnosis.
Q, MD · Not my job
Some things, and that's expected. The map is a schematic, and no schematic can be every heart. When your case doesn't fit, your judgment wins: describe it in the draft and correct the category if needed. What the map can't represent today, and the known gaps in the algorithm, are listed and kept up to date on Known limitations (under construction).
Claudia · Explains
The case is drawn and the report is written in your browser, and the case is never sent to the cctamap.com servers. What does get sent is anonymous usage counts, such as how many segments you marked (never which ones). Google Analytics and Cloudflare Web Analytics also run on the page; the details are in the Terms, §6. One rule covers everything: no names, record numbers or dates of birth, anywhere. That means not in the draft, not next to a shared link and not in Feedback.
Claudia · Explains
The code looks like CCTM2.<data>.<checksum>. It holds the drawn case: dominance, RI, the lesions in each segment, N, bridges, P, ischemia, grafts, collaterals, anomalies, the valve, plus quality, setting and the indication you picked from the list. It doesn't hold your edited draft. It isn't encrypted: anyone with the link can read the findings, and the checksum only catches copy errors, it isn't a signature. The QR is the same link, so the same rule applies: never put identifiers next to it.
Claudia · Heads-up!
Anything you don't mark is written as "no lesions": it's a normal template. If you simply didn't assess a segment, use Not evaluated in the vessel editor; the report says so, and the category doesn't change. Nondiag. (N) is for a segment you tried to read but couldn't, because of motion or artifact, and it does change the category (see #9).
Claudia · Explains
Tap or click a vessel to open its editor. Pick the stenosis grade, the plaque type and any HRP features, or mark Stent, Nondiag. or Not evaluated. To mark just a stretch, drag along the vessel; on a touchscreen, hold your finger still for a moment, then slide. A plaque can cross from one segment into the next, and each segment keeps its own grade. For a focal lesion right at a junction or bifurcation, SCCT 2026 assigns it to the preceding (more proximal) segment, so mark it there.
Claudia · Explains
Claudia · Explains
Copy report puts both rich text and plain text on the clipboard, so Word and web-based RIS keep the bold, and plain-text systems get clean lines. A short disclaimer is added at the end. Word downloads a .doc file (HTML inside) with the map, the category and the report; open it and "Save as .docx" if you need to. Map image gives you a PNG of about 2000 px with the map, the category, the legend and a QR code. The QR is on by default (untick "QR" to leave it out), and the PNG doesn't include the report text. The usual setup is the text in the RIS and the PNG in the PACS; PDF / Print gives you the whole sheet.
Claudia · Heads-up!
They're preset: Study quality starts at "good" and Clinical setting at "Stable", and both are printed. Change them, or set quality to "—" to leave it out. The Indication is only printed and doesn't change the recommendation; the Clinical setting does. So if your indication is acute chest pain, switch the setting to Acute yourself. Acute gives you the CAD-RADS 2.0 recommendations for acute chest pain when you write the report, but it isn't an emergency tool: critical findings still go straight to the referring physician.
Q, MD · Heads-up!
Not for that. An Agatston above 0 with no lesions marked gives CAD-RADS 1/P(n), and the template describes every vessel as having no lesions. That isn't a calcium-score report: a standalone calcium score is reported with CAC-DRS, which the map doesn't do.
Claudia · Explains
Right away, click Undo in the message that appears for about 6 seconds. Clear all doesn't ask first, and once that message is gone there's no going back. The same message appears after a random example, a deleted lesion, an anatomy change or removing the valve. Inside the vessel editor, ↶ undoes step by step. On a keyboard, Ctrl/⌘+Z undoes the last lesion change, but not while you're typing in a field, and not a Clear all. And if you reload the page, your case comes back ("Case restored · Start over").
Claudia · Heads-up!
The report comes out in the page's language, and any of the 15 works. Switching languages brings your case along, but a draft you've already edited stays in the language you wrote it in. ↻ Rebuild from map rewrites it in the new language, and your edits are lost. Tip: pick the language before you start editing.
Q, MD · Explains
CAD-RADS 2.0 gives one category per patient, set by the most relevant stenosis among the segments you marked; the map doesn't measure calibers, it counts what you mark. The map checks in this order:
The reason shown next to the category tells you which stenosis range set it.
Q, MD · Heads-up!
CAD-RADS 2.0 calls a plaque high-risk only when that same plaque has two or more of these: low attenuation (<30 HU), positive remodeling, spotty calcification, or the napkin-ring sign. One feature alone gets described, but it doesn't add /HRP. Features also need a stenosis grade and a plaque type first.
Q, MD · Explains
When at least one segment is nondiagnostic, look at the highest stenosis among the segments you could read:
Setting the study quality to "nondiagnostic" triggers the same rule.
Q, MD · Heads-up!
4A is a severe stenosis (70–99 %) in one or two vessels. 4B is an LM stenosis ≥50 %, or ≥70 % in all three main vessels — LAD, LCx and RCA. Three vessels at 50–69 % are still 3, and an LM at 50–69 % is already 4B. For the three-vessel rule, the map counts the main segments of each vessel plus the PDA and the posterolateral branches on the dominant side; diagonals, OMs and the ramus intermedius don't count toward 4B.
Q, MD · Explains
The 2026 SCCT consensus aligns reporting with CAD-RADS 2.0, and the map already follows it:
All eight, with quotes from both documents, are on the SCCT 2026 vs 2014 glossary page.
Claudia · Explains
Yes, research and teaching are welcome; just cite it: > Cuevas Cueto DF. CCTA Map: coronary lesion map and CAD-RADS 2.0 structured-reporting template [software]. Version 2.0. 2026. https://cctamap.com
The author's ORCID is 0000-0002-9604-2111. Add the date you used it.
Claudia · Not my job
It isn't open source: all rights reserved. You can save a copy for your own personal use on your computer; it's a single file. Redistributing it, modifying it, hosting it for others or using it commercially needs written permission: [email protected].
Claudia · Explains
Use the 💬 Feedback button (please, no patient data in it), or write to [email protected]. The most useful thing you can send is the case code (Code / QR → Copy code), because it rebuilds exactly what you drew. Add the category you expected and the version shown in the footer.