European heart journal. Imaging methods and practice最新文献

{"title":"Multimodality echocardiography in structural heart disease: the evolving role of the interventional imager.","authors":"Nikolaos Ktenopoulos, Konstantina Vlasopoulou, Panayotis Vlachakis, Anastasios Apostolos, Ioannis Skalidis, Paschalis Karakasis, Nikolaos Tsiamis, Theoni Theodoropoulou, Panagiotis Iliakis, Maria Drakopoulou, Andreas Synetos, George Latsios, Konstantina Aggeli, Konstantinos Tsioufis, Konstantinos Toutouzas","doi":"10.1093/ehjimp/qyag144","DOIUrl":"10.1093/ehjimp/qyag144","url":null,"abstract":"<p><p>Over the last decade, transcatheter structural heart interventions (TSHIs) have revolutionized the management of patients with structural heart disease (SHD), particularly those deemed high-risk or inoperable for conventional surgery. This rapid evolution has been propelled by innovations in both device technology and cardiovascular imaging, with echocardiography emerging as a cornerstone for procedural planning, real-time guidance and post-procedural assessment. This review outlines the expanding role of echocardiography across the spectrum of TSHIs, highlighting the importance of multimodality imaging, including three-dimensional transoesophageal echocardiography (3D TEE), intracardiac echocardiography (ICE) and fusion imaging techniques, for comprehensive structural evaluation and intraprocedural navigation. As the field continues to evolve, the demand for imaging specialists with procedural expertise is growing. Challenges remain in optimizing workflow, minimizing radiation exposure and enhancing image-guided precision. This review aims to outline the development of interventional imaging and promote best practices for procedural success and patient safety.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"4 3","pages":"qyag144"},"PeriodicalIF":0.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transoesophageal echocardiography as complementary imaging during pulsed field ablation of atrial fibrillation: a practical step-by-step approach.","authors":"Federico Marchini, Matteo Arzenton, Federica Frascaro, Luca Canovi, Michele Malagù, Francesco Vitali, Sofia Meossi, Laura Rotondo, Gianluca Campo, Matteo Bertini, Rita Pavasini","doi":"10.1093/ehjimp/qyag155","DOIUrl":"10.1093/ehjimp/qyag155","url":null,"abstract":"<p><strong>Aims: </strong>Transoesophageal echocardiography (TOE) provides real-time soft-tissue anatomical information during pulsed field ablation (PFA) of atrial fibrillation. This focused technical report describes a standardized workflow in which TOE complements, rather than replaces, fluoroscopic, and angiographic guidance throughout the procedure.</p><p><strong>Technique: </strong>The workflow is organized into four consecutive phases: pre-procedural assessment, transseptal puncture, ablation-catheter configuration and positioning at the pulmonary vein ostia, and post-procedural assessment. Pre-procedural TOE focuses on exclusion of left atrial appendage thrombus, definition of pulmonary vein anatomy, assessment of the interatrial septum, and baseline evaluation for pericardial effusion. During transseptal access, orthogonal bicaval and short-axis views support puncture-site selection and continuous visualization of septal tenting, while fluoroscopy remains integral to guidewire and transseptal-system manipulation. During ablation, TOE complements fluoroscopic/angiographic guidance by depicting catheter configuration and its relationship with the pulmonary vein ostia and adjacent soft-tissue structures. At procedure completion, TOE is used to assess the iatrogenic interatrial septal defect and to exclude new pericardial effusion.</p><p><strong>Conclusion: </strong>TOE should be considered a complementary imaging modality during fluoroscopy- and angiography-guided PFA rather than a replacement for these techniques. Its principal contribution is real-time visualization of soft-tissue anatomy, transseptal puncture, catheter-tissue relationships, and immediate post-procedural complications. Prospective studies are required to quantify its incremental clinical value.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"4 3","pages":"qyag155"},"PeriodicalIF":0.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13564227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Clinical applications of co-registered myocardial T2 mapping and dual bright- and black-blood late gadolinium enhancement magnetic resonance imaging.","authors":"","doi":"10.1093/ehjimp/qyag138","DOIUrl":"https://doi.org/10.1093/ehjimp/qyag138","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ehjimp/qyag030.].</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"4 3","pages":"qyag138"},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echoes without borders: a pursuit of global echocardiography education.","authors":"Hatem Soliman Aboumarie","doi":"10.1093/ehjimp/qyag152","DOIUrl":"10.1093/ehjimp/qyag152","url":null,"abstract":"","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"4 3","pages":"qyag152"},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13582015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bringing paediatric coronary artery abnormalities into view: the role of virtual reality.","authors":"Carol Wing-Kei Ng, Maggie Yin-Ting Chiu, Samuel Chung-Sum Ho, Elaine Yee-Ling Kan, Yiu-Fai Cheung","doi":"10.1093/ehjimp/qyag151","DOIUrl":"10.1093/ehjimp/qyag151","url":null,"abstract":"<p><strong>Purpose: </strong>Virtual reality (VR) is increasingly being used to present imaging data of congenital cardiac cases for surgical and interventional planning, as well as for education. This study aims to explore the use of VR in illustrating coronary artery anomalies, leveraging its capability for interactive three-dimensional visualization and manipulation.</p><p><strong>Methodology: </strong>Seven paediatric cases with coronary artery pathologies were selected, representing both congenital and acquired anomalies. CT coronary angiography datasets were processed using the commercially available VR software Elucis for segmentation and visualization of coronary anatomy.</p><p><strong>Results: </strong>The study cohort comprised of seven paediatric patients, four infants (aged 2 days-11 months) with cardiac diagnoses of TGA with single coronary origin, ALCAPA (Anomalous Left Coronary Artery from the Pulmonary Artery), Kawasaki disease with right coronary artery aneurysm, Sinus of Valsalva aneurysm; and three teenagers (aged 13-16 years) with ALCAPA, Kawasaki disease with left anterior descending(LAD) artery aneurysm and Kawasaki disease with obstructed LAD and a LIMA(left internal mammary artery) graft. We were able to depict the coronary artery origins in all 7 cases with VR. Coronary artery aneurysms were well demonstrated in all the Kawasaki cases. Large collaterals in the ALCAPA were well shown by VR. The spatial relationship between the Sinus of Valsalva aneurysm and the coronary arteries were well demonstrated. Teenagers had larger coronaries and segmentation time used was less than that of infants (2 h vs. 1 h).</p><p><strong>Conclusion: </strong>VR of paediatric coronary anomalies is feasible and provides a practical tool for pre-surgical planning, interventional strategy development, and medical education.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"4 3","pages":"qyag151"},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13582018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-calcified plaque volume assessed by coronary computed tomographic angiography: prognostic significance, reproducibility, and temporal progression.","authors":"Salman Ansari, Matthew J Budoff","doi":"10.1093/ehjimp/qyag115","DOIUrl":"10.1093/ehjimp/qyag115","url":null,"abstract":"<p><strong>Aims: </strong>Coronary artery disease remains the leading cause of cardiovascular mortality worldwide, with a substantial proportion of acute coronary events arising from rupture of non-calcified, lipid-rich plaques not detected by conventional coronary artery calcium scoring. Coronary computed tomographic angiography (CCTA) enables direct visualization and volumetric quantification of non-calcified plaque volume (NCPV), capturing a biologically active component of coronary atherosclerosis. No comprehensive synthesis of NCPV's prognostic significance, measurement reproducibility, and pharmacological modifiability has been published. This review addresses that gap.</p><p><strong>Methods and results: </strong>We conducted a narrative review of published literature through March 2025 using PubMed, synthesizing evidence from multicentre trials and registry analyses. Studies including SCOT-HEART, ICONIC, CONFIRM, and PARADIGM demonstrate that NCPV is associated with major adverse cardiovascular events independent of coronary artery calcium score, cardiovascular risk scores, and stenosis severity. Low-attenuation plaque burden represents one of the strongest predictors of myocardial infarction. Non-obstructive high-risk plaques confer risk comparable to obstructive lesions without high-risk features. Sex-related differences in plaque composition are clinically relevant, with women demonstrating lower fibrous and fibrofatty plaque volumes than men. Artificial intelligence-based quantitative CCTA has improved reproducibility, with interobserver variability below 3%. Serial imaging demonstrates that NCPV is modifiable with intensive lipid-lowering therapy.</p><p><strong>Conclusion: </strong>NCPV assessed by CCTA represents a reproducible and prognostically relevant measure of coronary atherosclerosis that is responsive to therapy. Recent regulatory interest, including submission of a Biomarker Qualification Program Letter of Intent to the US Food and Drug Administration, highlights its potential role as a biomarker for clinical trial enrichment.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"4 3","pages":"qyag115"},"PeriodicalIF":0.0,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual standardized quantification of late gadolinium enhancement, a contour-less method for late gadolinium enhancement quantification.","authors":"Giovanni Donato Aquaro, Roberto Licordari, Carmelo De Gori, Giancarlo Todiere, Umberto Ianni, Andrea Barison, Antonio De Luca, Alessandro Folgheraiter, Crysanthos Grigoratos, Mattia Alberti, Lisa Fulceri, Marilena Lombardo, Raffaele De Caterina, Gianfranco Sinagra, Michele Emdin, Gianluca Di Bella","doi":"10.1093/ehjimp/qyag148","DOIUrl":"10.1093/ehjimp/qyag148","url":null,"abstract":"<p><strong>Aims: </strong>Late gadolinium enhancement (LGE) quantification by cardiovascular magnetic resonance is central to risk stratification in hypertrophic cardiomyopathy (HCM). Conventional techniques require contour tracing and region of interest (ROI) placement, which may reduce reproducibility and increase analysis time. We developed a novel visual approach, the visual standardized quantification (VISTAQ) of LGE, that does not require myocardial contouring, arbitrary ROI positioning, or dedicated post-processing software.</p><p><strong>Methods and results: </strong>LGE images from 400 patients (100 prior myocardial infarction, 250 HCM, and 50 other non-ischaemic heart diseases) were analysed. Reproducibility was assessed using the intra-class correlation coefficients (ICC) and Bland-Altman analysis. VISTAQ was compared with conventional methods [mean+2SD, +5SD, +6SD, full-width-at-half-maximum (FWHM), visual thresholding]. Prognostic performance was evaluated in 250 HCM patients. VISTAQ demonstrated excellent intra- and inter-observer reproducibility (ICC up to 0.98 and 0.97, respectively), consistent across disease subtypes. VISTAQ showed similar ICC to FWHM but significantly lower net and absolute inter-observer differences (median absolute difference: 1.3%). Mean+2SD markedly overestimated LGE, whereas mean+6SD slightly underestimated LGE compared with VISTAQ, mean+5SD, FWHM, and visual thresholding. Analysis time was shorter with VISTAQ (median 105 vs. 375 s, <i>P</i> < 0.0001). During follow-up, 21 hard cardiac events occurred in HCM population. An LGE threshold >10% predicted events with higher accuracy using VISTAQ [area under the curve (AUC): 0.90; sensitivity: 85%; specificity: 94%) compared with mean+6SD (AUC: 0.75; sensitivity: 57%; specificity: 93%).</p><p><strong>Conclusion: </strong>VISTAQ provides highly reproducible, time-efficient LGE quantification without dedicated software and demonstrates non-inferior prognostic discrimination in HCM compared with conventional threshold-based techniques.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"4 3","pages":"qyag148"},"PeriodicalIF":0.0,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stress CT myocardial perfusion imaging after arterial switch operation for transposition of the great arteries.","authors":"Christos Gkizas, Benjamin Longere, Olivia Domanski, Aimee Rodriguez-Musso, Mehdi Haidar, Mariia Tregubova, Cedric Delhaye, Cedric Croisille, Francois Godart, Francois Pontana","doi":"10.1093/ehjimp/qyag139","DOIUrl":"10.1093/ehjimp/qyag139","url":null,"abstract":"<p><strong>Aims: </strong>Coronary abnormalities are late complications of arterial switch operation for transposition of the great arteries (ASO-TGA) and may remain silent for decades. We evaluated the feasibility and diagnostic performance of stress CT myocardial perfusion imaging (CT-MPI) in adults after ASO.</p><p><strong>Methods and results: </strong>Consecutive adults referred for clinically indicated coronary CT angiography (CCTA) underwent regadenoson stress CT-MPI using either dynamic energy-integrating detector CT (EID-CT) with quantitative myocardial blood-flow mapping or static photon-counting detector CT (PCCT) with qualitative and semiquantitative iodine-map assessment. All patients underwent stress cardiac magnetic resonance imaging (CMR) and invasive coronary angiography (ICA) within 3 months. Stress CMR served as the functional reference standard and ICA as the anatomical reference standard. Thirty-six patients were included (29 men; median age, 33.5 years), with 18 examined using each CT-MPI technique. Median neo-aortic diameter was 42 mm. At the per-segment level, CT-MPI achieved 95.5% sensitivity, 99.6% specificity, and 99.5% accuracy vs. stress CMR. In technique-stratified coronary-territory analyses, accuracy was 98.1% for static PCCT-MPI and 100% for dynamic EID-CT MPI. Against ICA, per-vessel sensitivity, specificity, and accuracy for obstructive coronary artery disease were 70.0%, 100%, and 98.6%, respectively. Coronary stenosis and a smaller coronary take-off angle were associated with ischaemia, whereas aortic dimension was not. A negative CT-MPI could have obviated additional testing in 30 of 36 patients (83.3%).</p><p><strong>Conclusion: </strong>Stress CT-MPI combined with CCTA was feasible and demonstrated high diagnostic performance for detecting myocardial ischaemia after arterial switch operation. Larger prospective studies are needed to confirm these findings and define its clinical role.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"4 3","pages":"qyag139"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomic entrainment to expressive musical phrase structures.","authors":"Natalia Cotic, Vanessa C Pope, Mateusz Soliński, Pier D Lambiase, Elaine Chew","doi":"10.1093/ehjimp/qyag149","DOIUrl":"10.1093/ehjimp/qyag149","url":null,"abstract":"<p><strong>Aims: </strong>Music reliably influences autonomic physiology, yet the mechanisms linking expressive music structures to cardiorespiratory responses remain poorly understood. This study investigated how phrase-level organization in loudness and tempo relates to autonomic entrainment during music listening.</p><p><strong>Methods and results: </strong>We analysed multimodal physiologic recordings [electrocardiogram(ECG)-derived R-to-R intervals, respiration, continuous blood pressure (BP)] from 126 participants in the HeartFM study, each of whom listened to nine expressive solo-piano tracks drawn from a set of 30 (8 original + 22 feature-modulated versions) rendered on a reproducing piano. Music phrase structures were extracted using a Bayesian arc-detection algorithm, generating beat-level boundary profiles for loudness and tempo. Physiologic signals were converted into smooth envelopes and resampled onto the music-beat grid. Entrainment strength was quantified using Earth Mover's Distance (EMD) between boundary profiles and physiologic envelopes, and evaluated against surrogate distributions. Participant-specific surrogate testing showed that original-vs.-surrogate separation was heterogeneous across physiological signals, with the strongest trend observed for tempo-BP waveform pairings. In contrast, loudness phrases showed consistently lower EMD than tempo phrases across most tracks. Phrase-arc summary statistics (mean and variability of arc length) and music-feature similarity provided measures of predictability. These metrics correlated with entrainment strength; more regular phrase structures were associated with greater synchronization.</p><p><strong>Conclusion: </strong>Autonomic activity can be mapped to expressive phrase structures, with loudness showing stronger morphology-based alignment than tempo. Predictable phrasing and cross-feature congruence led to greater synchronisation. These findings characterize music-physiology coupling as a structure-dependent, quantifiable phenomenon, providing a mechanistic basis for feature-specific selection of music for eliciting autonomic responses.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"4 3","pages":"qyag149"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-based pulmonary artery to ascending aorta ratio on non-contrast CT for pulmonary hypertension: diameter vs. volume assessment.","authors":"Turki Nasser Alnasser, Alireza Hokmabadi, Ahmed Maiter, Michael Sharkey, Christopher Johns, Smitha Rajaram, David G Kiely, Samer Alabed, Andrew J Swift","doi":"10.1093/ehjimp/qyag146","DOIUrl":"10.1093/ehjimp/qyag146","url":null,"abstract":"<p><strong>Aims: </strong>To assess the diagnostic accuracy of a deep learning (DL) model for quantifying the pulmonary artery (PA) and ascending aorta (AAo) diameters and volumes on non-contrast computed tomography (CT) scans for detecting pulmonary hypertension (PH).</p><p><strong>Methods and results: </strong>The PA and AAo were segmented using a validated DL model on non-contrast CT scans. PA/AAo ratios were quantified using diameter and volume measurements. Testing was performed using two independent patient cohorts. A first cohort (<i>n</i> = 97) was used to compare DL-derived and manual diameter-based PA/AAo ratios and to evaluate their diagnostic accuracy against right heart catheterization (RHC). A second cohort (<i>n</i> = 425; 385 internal and 40 external patients) was then used to compare the diagnostic performance of the DL-derived diameter- and volume-based PA/AAo ratios using RHC as the reference standard. In the first cohort, 97 patients were included (mean age 63 ± 13 years, 50% female, and 62 patients with PH). Agreement with the diameter-based approach was good [Observer 1: intraclass correlation coefficient (ICC) = 0.79 (0.70-0.85); Observer 2: ICC = 0.79 (0.70-0.86)]. Agreement with volume-based PA/AAo ratio was moderate [Observer 1: ICC = 0.56 (0.41-0.68); Observer 2: ICC = 0.55 (0.39-0.67)]. The DL diameter-based (area under the curve (AUC) = 0.83) and volume-based (AUC = 0.84) PA/AAo ratio outperformed the manual measurements by Observer 1 (AUC=0.72) and Observer 2 (AUC = 0.74). The second cohort comprised 425 patients (385 internal and 40 external), with a mean age of 65 ± 12 years, 60% female, and 353 patients with PH. The volume-based approach achieved superior diagnostic accuracy compared with the diameter-based approach (AUC 0.85 vs. 0.73), with higher sensitivity (66% vs. 41%) and specificity (89% vs. 82%).</p><p><strong>Conclusion: </strong>The PA/AAo volume ratio on non-contrast CT demonstrates high diagnostic accuracy for detecting PH and could assist with opportunistic detection of PH in patients undergoing routine chest imaging.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"4 3","pages":"qyag146"},"PeriodicalIF":0.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}