Artificial intelligence applied to coronary artery calcium (CAC) scans can provide information beyond what is currently reported. The AI-CVD initiative aims to opportunistically extract all actionable information from CAC scans and lung scans. We have recently shown that AI-CVD opportunistic screening for enlarged cardiac chambers particularly left atrium (LA) and left ventricle, and increased left ventricular (LV) mass in CAC scans predicts future atrial fibrillation (AF) and heart failure (HF)…
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CT derived fractional flow reserve: Part 1 – Comprehensive review of methodologies
This review examines methodologies employed in deriving physiology from cardiac computed tomography angiography (CCTA), focusing on two primary approaches:1) fractional flow reserve (FFR) calculated from CT images using computational fluid dynamics (CT-FFR); and 2) plaque-derived ischemia/FFR assessment utilizing artificial intelligence and quantitative metrics. Each methodology offers unique advantages in diagnosing and managing coronary artery disease, contributing to CCTA’s evolution into a d…
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Key takeaways from the 2025 expert consensus document on cardiac computed tomography for prosthetic heart valve assessment
The 2025 SCCT/ACC/ESCR/NASCI/RSNA/SCAI/STS expert consensus document provides guidance on the appropriate performance, utilization and interpretation of cardiac CT (CT) for assessing prosthetic heart valves (PHV).1 We highlight our Top 10 recommendations from this practical document which supports the clinical utilization of this imaging modality:
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CCTA and CACS for preoperative cardiovascular risk stratification in patients undergoing noncardiac surgery: A systematic review and meta-analysis
Major Adverse Cardiovascular Events (MACE) is a common cause of perioperative and long-term morbidity and mortality following noncardiac surgery. Patients who require preoperative cardiovascular risk stratification, traditionally undergo noninvasive cardiac imaging using myocardial perfusion imaging or stress echocardiography. Coronary Computed Tomography Angiography (CCTA) and Coronary Artery Calcium Score (CACS) have demonstrated prognostic value in predicting postoperative MACE and effectivel…
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Flow dynamic differences between Kawasaki Disease patients with coronary artery aneurysms and ectasia
Untreated Kawasaki Disease (KD) can lead to coronary artery (CA) dilations, such as CA aneurysms (CAA), CA ectasia (CAE), or both (CAA + CAE). Currently, therapeutic decisions rely solely on geometric measurements, which have limitations. This study aims to correlate differences in flow dynamics between CAA, CAE, and CAA + CAE with clinical outcomes and thrombotic potential.
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Artificial intelligence in Pre-TAVR coronary evaluation: A step forward
Coronary artery disease (CAD) frequently coexists with severe aortic stenosis (AS) and is present in up to 50 % of patients undergoing transcatheter aortic valve replacement (TAVR).1 Given its prognostic implications and the overlap in symptoms between CAD and AS, accurate assessment of CAD is an important component of pre-TAVR evaluation. While invasive coronary angiography (ICA) remains the gold standard, there is growing evidence for coronary computed tomography angiography (CCTA) in evaluat…
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Central and peripheral artery stiffness: Key players in cardiovascular disease risk
The large arteries were once considered inert conduits, delivering oxygenated blood to peripheral tissues. However, large arteries have an important physiological role in buffering the cyclical changes in blood pressure (BP) resulting from intermittent ventricular ejection. With ageing and exposure to cardiovascular disease (CVD) risk factors, the large arteries stiffen, with adverse consequences for the major organs. Indeed, central (elastic) arterial stiffness is now recognized as key, indepen…
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Discrete non-calcified plaque is associated with increased major adverse cardiovascular events in a high cardiovascular risk population with low coronary artery calcium scores (0–100)
Table of Contents Summary: This article identified predictors for discrete non-calcified plaque (NCP) and future adverse cardiovascular events (CVEs) in symptomatic patients from a high cardiovascular risk population with no known coronary artery disease and coronary artery calcium (CAC) scores of 0–100. Risk factors such as hyperlipidemia, diabetes mellitus, tobacco use, older age, elevated systolic blood pressure, and higher total CAC scores were associated with NCP presence. Patients with NCP…
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Coronary computed tomography angiography radiomics for predicting major adverse cardiovascular events after percutaneous coronary interventions
Radiomics, which leverages advanced image analysis to extract quantitative data, holds promise for improving risk stratification in cardiovascular imaging.1 While artificial intelligence has demonstrated utility in the cardiovascular field,2 the potential of coronary computed tomography angiography (CCTA) radiomics for predicting post-PCI clinical outcomes remains unclear. We recently reported that the coronary artery calcium (CAC) score in CCTA effectively predicts clinical events following per…
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Comparison of single-source cardiac CT and CMR quantified ventricular volumes and function in congenital heart disease
We compared single-source cardiac CT (CCT) and cardiac MRI (CMR) measurements of right ventricular (RV) volumes and function in congenital heart disease (CHD) patients. CCT consistently measures higher RV volumes and lower ejection fraction (EF) compared to CMR, with the greatest difference between contours in the basal and mid-inferior RV segments. The findings suggest that CMR-derived pulmonary valve replacement (PVR) criteria, when applied to CCT, lead to earlier intervention. Adjusting CCT m…