Our understanding of the world has been shaped by Euclidean geometry—length, area, volume. However, Euclidean tools, grounded in idealized shapes such as spheres, cubes, and pyramids, provide only limited descriptive power for the irregular, jagged, and heterogeneous forms characteristic of natural phenomena, such as mountains or biological organisms [1]. For decades, medicine has relied on smoothing these rough forms into simple shapes to make them measurable. But cardiac structures— coronary a…
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Reply to the commentary by Dong et al.: Appraising the CCTA-SCAD study: Current challenges and future perspectives in diagnosing acute spontaneous coronary artery dissection
We thank Dr. Dong et al. for their expedient and thorough appraisal. We agree with most of their comments.
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Response to Letter – referencing JCCT-D-25-426 ‘‘Integrating radiomics into coronary computed tomography angiography: Enhancing prognostic value after percutaneous coronary intervention’’ by Macit Kalçık et al.
We sincerely thank Dr. Macit Kalçık and colleagues for their thoughtful comments on our article. Their remarks aptly highlight the significance of integrating radiomics into coronary computed tomography angiography (CCTA) as a means to advance risk stratification in clinical practice.
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High-risk plaques in proximal and distal segments relative to graft anastomoses and non-grafted segments
Coronary artery bypass grafting (CABG) is the preferred invasive treatment option for complex coronary artery disease (CAD), bypassing flow-limiting lesions and high-risk plaques (HRP), thereby reducing clinical events. It also provides graft collateralization, preventing cardiac events due to proximal plaque rupture or erosion, and vessel occlusion. This study evaluated the prevalence of HRPs in segments proximal and distal to graft anastomoses and in non-grafted segments, using coronary comput…
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Incremental value of a CCTA-derived AI-based ischemia algorithm over standard CCTA interpretation of predicting myocardial ischemia in patients with suspected coronary artery disease
A novel artificial intelligence-guided quantitative computed tomography ischemia algorithm (AI-QCTischemia) comprises a machine-learned method using atherosclerosis and vascular morphology features from coronary computed tomography angiography (CCTA) images to predict myocardial ischemia. This study evaluates the diagnostic performance of AI-QCTischemia compared to standard CCTA interpretation in detecting myocardial ischemia.
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Appraising the CCTA-SCAD study: Current challenges and future perspectives in diagnosing acute spontaneous coronary artery dissection
We have read with great interest the recent publication by Pagonis C et al., entitled “An in-depth analysis of coronary computed tomography angiography segmental findings in acute spontaneous coronary artery dissection – a prospective multicenter study”.1 In this study, segment-level agreement between coronary computed tomography angiography (CCTA) and invasive coronary angiography (ICA) for the diagnosis of acute spontaneous coronary artery dissection (SCAD) is analyzed. This study adds value t…
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Optimizing contrast administration in pediatric cardiovascular CT: Safety and technique
Pediatric cardiac computed tomography angiography (CCTA) is rapidly becoming a standard diagnostic tool for congenital heart disease imaging due to its effectiveness. This review provides an in-depth look at contrast administration in pediatric cases, focusing on how physiological differences influence the choice, dosage, and delivery of iodinated contrast agents. It underscores the safety considerations of these agents, the role of risk categorization before contrast administration, and the nee…
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Low and ultralow CAC: Signal, noise or something more?
Coronary artery calcium (CAC) testing occupies a sweet spot in preventive cardiology: it is quick, inexpensive, easy to interpret, and both specific and sensitive for clinically relevant coronary atherosclerosis. Yet the ability to separate true zero from nonzero scores, the central distinction that makes CAC so powerful, also raises questions about how we should interpret the growing evidence around low (0–100), ultralow (0.1–0.9) and subthreshold CAC scores.
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Quo Vadis artificial intelligence assisted analysis of coronary stenosis?
The diagnostic accuracy of coronary computed tomography (CT) angiography against the reference standard of invasive coronary angiography (ICA) was established almost 20 years ago based on the visual assessment of coronary stenosis severity.1–3 In clinical practice, the evaluation of coronary CT angiography datasets is achieved through interactive assessment of the axial images, multiplanar reformatted reconstructions, and maximum intensity projection images.4,5 The visual assessment of coronary …
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New anatomical classification to plan transcatheter correction of sinus venosus defect based on 3D models
Superior sinus venosus defect (SVD) is a complex congenital heart disease (CHD) with a wide spectrum of anatomical variants. The innovative transcatheter correction of SVD (TCSVD) is feasible in selected cases. Patient selection requires a detailed anatomical evaluation. This study aims to provide an anatomical classification of SVD using 3D models.