The international journal of cardiovascular imaging最新文献

{"title":"Prognostic significance of coronary flow velocity reserve in patients with peripheral arterial disease.","authors":"Lauro Cortigiani, Nicola Gaibazzi, Quirino Ciampi, Domenico Tuttolomondo, Rebecca Navacchi, Francesco Bovenzi, Scipione Carerj, Mauro Pepi, Patricia A Pellikka, Eugenio Picano","doi":"10.1007/s10554-025-03411-z","DOIUrl":"https://doi.org/10.1007/s10554-025-03411-z","url":null,"abstract":"<p><strong>Background: </strong>Patients with lower extremity peripheral arterial disease (PAD) have a higher risk of cardiovascular events. Stress echocardiography (SE) based on regional wall motion abnormality (RWMA) is imperfect for risk stratification in PAD, but it can be complemented with an assessment of coronary flow velocity reserve (CFVR) in the mid-distal left anterior descending coronary artery.</p><p><strong>Objective: </strong>To assess the value of SE with RWMA and CFVR to predict survival in PAD.</p><p><strong>Methods: </strong>In a retrospective analysis of prospectively acquired data in an observational, multicenter study, we recruited 359 patients (age 69 ± 8 years, 240 [67%] males) with PAD referred for dipyridamole SE in 3 accredited laboratories. We assessed RWMA and CFVR (abnormal value ≤ 2.0). All patients were followed up for a median of 4.7 (interquartile range: 2.0 to 8.2 years). All-cause death was the outcome end-point.</p><p><strong>Results: </strong>The positivity rate was 37/359 (10%) for RWMA and 159/359 (44%) for CFVR. During follow-up, 97 (27%) deaths were registered. At multivariable analysis, inducible RWMA and/or CFVR ≤ 2.0 (HR 2.58, 95% CI 1.65-4.04; p < 0.0001), age ≥ 70 years, diabetes, dialysis treatment, and ejection fraction ≤ 50% were associated with decreased survival. The annual mortality was 7.4% in patients with RWMA and/or CFVR ≤ 2.0 and 2.7% in those with no RWMA and CFVR > 2.0 (p < 0.0001).</p><p><strong>Conclusion: </strong>In patients with PAD, SE shows more than 4-fold higher prevalence of abnormal CFVR compared to RWMA. The prognostic value of CFVR outperforms RWMA, showing the importance of coronary microvascular dysfunction and diffuse, subcritical coronary atherosclerosis in determining the outcome.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clarifying the cardiovascular morphology and associated abnormalities in patients with tricuspid Atresia using multidetector computed tomography angiography.","authors":"Damandeep Singh, Niraj Nirmal Pandey, Mansi Verma, Vineeta Ojha, Avichala Taxak, Sanjeev Kumar, Sivasubramanian Ramakrishnan, Priya Jagia","doi":"10.1007/s10554-025-03423-9","DOIUrl":"https://doi.org/10.1007/s10554-025-03423-9","url":null,"abstract":"<p><p>The present study sought to assess the intracardiac morphology and associated cardiovascular anomalies in patients with tricuspid atresia using multidetector CT angiography. CT angiography datasets of all patients diagnosed with tricuspid atresia at our institution between November 2014 and December 2021 were retrospectively reviewed. The type of tricuspid atresia and associated cardiovascular structural anomalies detected on CT angiography were evaluated. Tricuspid atresia was identified in 404 patients (276 males [68.3%]; mean age at diagnosis: 4.54 ± 6.61 years [range: 9 months-40 years]). Right isomerism was observed in 12/404 (3%) patients followed by situs inversus in 9/404 (2.2%) and left isomerism in 1/404 (0.2%) patients respectively. All patients (404/404; 100%) had an atrial septal defect and a hypoplastic right ventricle while a ventricular septal defect was seen in 403/404 (99.8%) patients. The most common type based on ventriculo-arterial morphology was Type I, with normally related great vessels (78.5%) followed by Type II, with transposed great arteries (21%) and Type III, with common arterial trunk (0.5%). Pulmonary stenosis and pulmonary atresia were seen in 296/404 (73.26%) and 55/404 (13.6%) patients respectively. A right-sided aortic arch with mirror image branching pattern was seen in 38/404 (9.4%) patients. A patent ductus arteriosus was seen in 100/404 (24.8%) patients. Coronary artery anomalies were observed in 34/404 (8.4%) patients. Tricuspid atresia is a congenital heart defect associated with an array of cardiovascular lesions, most commonly septal defects, conotruncal anomalies and pulmonary outflow tract obstruction. A comprehensive evaluation of cardiovascular morphology using CT angiography may thus prove crucial prior to surgery/interventions in these patients.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproducibility and reliability of flow quantification using CMR 2D-phase contrast and 4D-Flow in secondary mitral valve regurgitation.","authors":"Yasaman Safarkhanlo, Martina Boscolo Berto, Giancarlo Spano, Benedikt Bernhard, Jonathan Schütze, Anselm W Stark, Fabien Praz, Isaac Shiri, Alan A Peters, Christof Schaub, Eva S Peper, Chrysoula Garefa, Andreas Wahl, Jessica A M Bastiaansen, Christoph Gräni","doi":"10.1007/s10554-025-03421-x","DOIUrl":"https://doi.org/10.1007/s10554-025-03421-x","url":null,"abstract":"<p><p>Accurate quantification of mitral valve regurgitation (MVR) is crucial for patient management. While different MVR quantification methods based on cardiac magnetic resonance imaging (CMR) exist, their reproducibility and reliability remain uncertain. This study aims to evaluate the reproducibility of different CMR 2D-phase contrast (PC) and 4D-flow MVR quantification methods. The inter-reader and intra-reader reproducibility were assessed using intraclass correlation coefficients (ICC). Seven methods were evaluated: 2D-PC standard (LVSV minus aortic flow), 2D-PC mitral-aortic (mitral inflow minus aortic flow), 2D-PC direct (quantifying mitral backflow), 4D-flow standard, 4D-flow mitral-aortic, 4D-flow direct, and volumetric method (LVSV minus RVSV) in 32 patients (74.8 ± 9.8 years, 28% females) with secondary MVR, analyzed independently by two experienced readers. A total of 26 patients were included in the analysis for 2D-PC and 15 for 4D-flow methods. Among all techniques, 2D-PC standard was the most reliable method with both good inter-reader (ICC = 0.85, p < 0.001) and intra-reader agreement (ICC = 0.87, p < 0.001). The 4D-flow standard (ICC = 0.97, p < 0.001) and the volumetric method (ICC = 0.81, p < 0.001) showed excellent and good intra-reader agreements, respectively, but only moderate inter-reader reproducibility (ICC = 0.52, p = 0.027 and ICC = 0.71, p < 0.001). In patients with secondary MVR, 2D-PC standard method demonstrated the highest reproducibility, while 4D-flow methods showed excellent intra-reader reliability but more variable inter-reader agreement. Standardized post-processing protocols and training would likely enhance the clinical application of these techniques. Future studies should investigate these methods in larger, diverse cohorts and correlate findings with clinical outcomes.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical value of dual-phase CT angiography (CTA) of the pulmonary artery and bronchial artery in diagnosing bronchial artery-pulmonary artery fistula.","authors":"Wenbin Zhang, Yan Wu, Dan Han, Yang Tian","doi":"10.1007/s10554-025-03418-6","DOIUrl":"https://doi.org/10.1007/s10554-025-03418-6","url":null,"abstract":"<p><p>To evaluate the diagnostic efficacy of dual-phase computed tomography angiography (CTA) in identifying bronchial artery-pulmonary artery fistulas (BPAF). A retrospective cohort study was conducted on 62 patients diagnosed with BPAF via dual-phase CTA at our institution between February 2022 and January 2025. Comprehensive analyses were performed to characterize vascular involvement patterns, ectopic vessel distribution, aberrant feeding vessels, and associated imaging features. Among the cohort, 26 patients (41.9%) presented with hemoptysis as the predominant symptom. Comorbid pulmonary conditions included bronchiectasis (54.8%, n = 34), atelectasis (16.1%, n = 10), chronic obstructive pulmonary disease (12.9%, n = 8), pulmonary embolism (6.4%, n = 4), pulmonary tuberculosis (3.2%, n = 2), fibrosing mediastinitis (3.2%, n = 2), and pneumoconiosis (3.2%, n = 2). Imaging revealed 82 BPAF lesions across 62 patients, with 12 cases (19.4%) demonstrating multi-vessel involvement. Anomalous vascular findings included non-bronchial systemic collaterals (n = 8, 12.9%) and ectopic bronchial artery origins (n = 6, 9.7%). Hallmark CTA features comprised tortuous bronchial artery dilation (100%), Phase-discordant opacification of pulmonary artery, delayed pulmonary artery opacification, and jet-like hypodense shadows within pulmonary arteries during the pulmonary phase. Dual-phase CT angiography (CTA) of the pulmonary artery and bronchial artery can better display the bronchial artery-pulmonary artery fistula and provide detailed and comprehensive treatment basis for clinical practice.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk stratification study of non-calcified coronary plaques based on CT pericoronary adipose tissue measurement.","authors":"Xiaoying Liu, Zhaowu Shen, Chenlin Yin, Weiyuan Zhang, Xia Li, Jie Jiang","doi":"10.1007/s10554-025-03425-7","DOIUrl":"https://doi.org/10.1007/s10554-025-03425-7","url":null,"abstract":"<p><p>To investigate the relationship between fat attenuation index (FAI) around non-calcified coronary plaques, noninvasive CT-derived fractional flow reserve (CT-FFR), and plaque parameters. The CT angiography images and clinical data of 395 hospitalized patients with suspected coronary heart disease (CHD) were retrospectively collected. Patients were divided into normal (n = 131), mild (n = 140), moderate (n = 78), and severe stenosis (n = 46) groups. All lesion groups had noncalcified plaques in a single coronary artery location (single-vessel disease). Plaque parameters, periplaque FAI, and CT-FFR were measured. Cases were stratified into high-risk (FAI ≥ -70.1 HU, n = 102) and low-risk (FAI < -70.1 HU, n = 293) groups. Coronary stenosis severity correlated positively with age (R²=0.277, P < 0.05), plaque short diameter (R²=0.257, P < 0.05), and FAI (R²=0.548, P < 0.05), and negatively with CT-FFR (R²=-0.387, P < 0.05). The high-risk FAI group had lower plaque CT values and CT-FFR (P < 0.05). FAI around non-calcified plaques correlates with stenosis severity and CT-FFR, offering a potential tool for risk stratification of acute coronary syndrome.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left atrial filling index and stiffness index and its correlation to the duration of diabetes in patients with type II diabetes mellitus.","authors":"Fatma Elhady, Asmaa Ahmed Ali, Naglaa Shaban Elkholy, Eman A El-Mnakhly, Taher Said Abd Elkareem, Ahmed Galal, Mahmoud A Negm","doi":"10.1007/s10554-025-03415-9","DOIUrl":"https://doi.org/10.1007/s10554-025-03415-9","url":null,"abstract":"<p><p>The left atrium (LA) has a vital role in diastolic function. One of the predictors of diastolic dysfunction (DD) is the LA reservoir strain. Beside this, stiffness of LA is considered another marker for LA function. Moreover, it is correlated with the degree of fibrosis than LA deformity itself. Aim of the study is to evaluate the LA phasic function, stiffness in patients with type II diabetes mellitus and whether these parameters could be the earlier markers of DD in T2DM. Also, to assess the effect of duration of T2DM on LA function. 103individuals, comprising 73patients with type II diabetes and 30 age and sex matched healthy control, depending on duration of diabetes, the patient group was classified into three groups, the first group (less than 10 years), group II (10-20 years) &group III (more than 20 years).2D-TTE was done for assessment of LA functions. Increased indexed LA volume (LAVI)&decreased LA phasic function in diabetic group(A). Elevated LA stiffness index earlier in diabetic patients (Group I) (p 0.02). There were significant differences between group I versus group II, III in LA function when measured by STE and between group I versus group II in LA stiffness index. We found that duration of diabetes is correlated negatively with LA function.LA filling index is positively correlated significantly with LA stiffness index p < 0.001, MV E, E/e', LAVI. The duration of diabetes was one of the predictors of LA dysfunction. Elevated LA stiffness with impaired its phasic function in diabetic patients. LA stiffness index and phasic function can be used as an earlier marker for diastolic dysfunction. Duration of diabetes has an effect on LA function and stiffness index.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitral annular plane systolic excursion to left atrial volume ratio - a strainless relation with left ventricular filling pressures.","authors":"Thomas Lindow, Hande Oktay Tureli, Charlotte Eklund Gustafsson, Daniel Manna, Björn Wieslander, Per Lindqvist, Ashwin Venkateshvaran","doi":"10.1007/s10554-025-03413-x","DOIUrl":"https://doi.org/10.1007/s10554-025-03413-x","url":null,"abstract":"<p><p>Left atrial reservoir strain (LASr) offers diagnostic and prognostic value in patients with heart failure. However, LASr may be technically challenging and is not available to all clinical echocardiographers. Since LASr is a consequence of left atrial (LA) stretch during apical descent of the mitral annulus, we hypothesized that a ratio between mitral annular plane systolic excursion (MAPSE) and LA volume (LAV) may offer similar diagnostic value as LASr. We aimed to investigate the relationship between MAPSE/LAV and LASr and evaluate the diagnostic performance of MAPSE/LAV to identify patients with elevated LV filling pressure. MAPSE/LAV and LA strain measures were obtained in patients referred for echocardiography due to aortic stenosis, and in patients who had undergone clinically indicated right heart catheterization (RHC) with simultaneous echocardiography. In 93 patients with moderate aortic stenosis, MAPSE/LAV was moderately correlated with LASr (r = 0.57) but was lower in patients with elevated compared to normal LV filling pressure by echocardiography (0.11 vs. 0.16 mm/mL, p < 0.001). In 72 patients who had undergone RHC and simultaneous echocardiography, MAPSE/LAV and LASr correlated weakly with pulmonary artery wedge pressure (PAWP) (r=-0.44 and r = 0.37). MAPSE/LAV was lower in patients with elevated (> 15 mmHg) vs. normal PAWP (0.14 mm/mL vs. 0.27 mm/mL). Accuracy for detection of elevated PAWP was similar for MAPSE/LAV (area under the curve MAPSE/LAV: 0.75 [0.58-0.92] and LASr: 0.75 [0.57-0.90]). Despite a moderate correlation with LASr, MAPSE/LAV provided similar diagnostic value as LASr in predicting elevated LV filling pressures as determined by echocardiography and RHC.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the recent advances in coronary artery disease imaging on pilot medical certification and aviation safety: current state and future perspective.","authors":"Mina M Benjamin, Mark G Rabbat, William Park, Maria Benjamin, Eddie Davenport","doi":"10.1007/s10554-025-03380-3","DOIUrl":"https://doi.org/10.1007/s10554-025-03380-3","url":null,"abstract":"<p><p>Coronary artery disease (CAD) is highly prevalent among pilots due to the nature of their lifestyle, and occupational stresses. CAD is one the most common conditions affecting pilots' medical certification and is frequently nondisclosed by pilots fearing the loss of their certification. Traditional screening methods, such as resting electrocardiograms (EKGs) and functional stress tests, have limitations, especially in detecting non-obstructive CAD. Recent advances in cardiac imaging are challenging the current paradigms of CAD screening and risk assessment protocols, offering tools uniquely suited to address the occupational health challenges faced by pilots. Coronary artery calcium scoring (CACS) has proven valuable in refining risk stratification in asymptomatic individuals. Coronary computed tomography angiography (CCTA), is being increasingly adopted as a superior tool for ruling out CAD in symptomatic individuals, assessing plaque burden as well as morphologically identifying vulnerable plaque. CT-derived fractional flow reserve (CT-FFR) adds a physiologic component to the anatomical prowess of CCTA. Cardiac magnetic resonance imaging (CMR) is now used as a prognosticating tool following a coronary event as well as a stress testing modality. Investigational technologies like pericoronary fat attenuation and artificial intelligence (AI)-enabled plaque quantification hold the promise of enhancing diagnostic accuracy and risk stratification. This review highlights the interplay between occupational demands, regulatory considerations, and the limitations of the traditional modalities for pilot CAD screening and surveillance. We also discuss the potential role of the recent advances in cardiac imaging in optimizing pilot health and flight safety.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-assisted CCTA: supporting diagnosis across the CAD spectrum.","authors":"Edoardo Conte, Elena Sala","doi":"10.1007/s10554-025-03414-w","DOIUrl":"https://doi.org/10.1007/s10554-025-03414-w","url":null,"abstract":"","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":"41 5","pages":"825-826"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence quantification and experienced reader computed tomography analysis for differentiating normal from minimally and mildly diseased coronary arteries: an early real-world compatibility study.","authors":"Amr Idris, Mahdi Hurreh, Thomas Knickelbine, João L Cavalcante, John R Lesser, Michael D Miedema, Jonathan Urbach, Marc C Newell, Melissa Aquino, Victor Y Cheng","doi":"10.1007/s10554-025-03366-1","DOIUrl":"10.1007/s10554-025-03366-1","url":null,"abstract":"<p><p>Differentiating normal from minimally and mildly diseased coronary arteries on coronary computed tomographic angiography (CCTA) is crucial, impacting treatment decisions due to the extremely low coronary artery event risk associated with the former. Artificial intelligence quantitative computed tomographic (AI-QCT) can potentially identify subclinical atherosclerosis in cases deemed normal by reader interpretation. We aimed to evaluate AI-QCT's ability to distinguish reader-determined normal coronary arteries from those with minimal and mild diseased on CCTA. We screened 849 consecutive patients without coronary artery stents or bypass grafts who underwent CCTA and AI-QCT for suspected coronary artery disease between October 2022 and February 2023. Clinical reads were blinded to AI-QCT results. 411 patients (mean age 60, 63% women) with qualifying results were categorized into normal coronary arteries (NORMAL: calcium score of 0 and reader CAD-RADS 0), minimal (MINIMAL: coronary calcium score of ≤ 10, CAD-RADS score of 1, and 1 or 2 segments with plaque), and mild (MILD: coronary calcium score > 10 and < 100, CAD-RADS 1 or 2, and 1-3 segments with plaque) disease based on reader interpretation. AI-QCT results were compared among the categories and Youden index directed area-under-curve (AUC) analysis was employed to determine the optimal total plaque volume threshold distinguishing NORMAL from the other categories. Among the 411 patients, there were 235 NORMAL, 46 MINIMAL, and 130 MILD cases. AI-QCT detected no total plaque in 61/235 (26.0%) NORMAL cases. From NORMAL to MINIMAL to MILD, AI-QCT showed significant stepwise increases in total plaque volume (mean 7.7 mm³ vs. 22.5 mm³ vs. 40.5 mm³, p < 0.001 all pairwise comparisons) and noncalcified plaque volume (mean 6.7 mm³ vs. 17.3 mm³ vs. 24.4 mm³, p < 0.01 all pairwise comparisons). An AI-QCT total plaque volume of < 12.3 mm³ identified 189/235 (80.4%) NORMAL cases and excluded 136/176 (77.3%) MINIMAL and MILD cases, with an AUC of 0.86. AI-QCT revealed significantly higher total plaque volume in reader-determined MINIMAL and MILD compared to NORMAL cases, showing promising concordance with reader interpretation. Our analysis suggests that an AI-QCT total plaque volume of < 12.3 mm³ may serve as a useful initial cut-off for CCTA likely to be interpreted as normal by an experienced reader.</p>","PeriodicalId":94227,"journal":{"name":"The international journal of cardiovascular imaging","volume":" ","pages":"889-898"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}