Machine learning to predict high-risk coronary artery disease on CT in the SCOT-HEART trial.

Background: Machine learning based on clinical characteristics has the potential to predict coronary CT angiography (CCTA) findings and help guide resource utilisation.

Methods: From the SCOT-HEART (Scottish Computed Tomography of the HEART) trial, data from 1769 patients was used to train and to test machine learning models (XGBoost, 10-fold cross validation, grid search hyperparameter selection). Two models were separately generated to predict the presence of coronary artery disease (CAD) and an increased burden of low-attenuation coronary artery plaque (LAP) using symptoms, demographic and clinical characteristics, electrocardiography and exercise tolerance testing (ETT).

Impact of cardiac phase selection on computational fluid dynamics analysis.

Background: The selection of cardiac phase in coronary computed tomography angiography (CCTA) may affect computational fluid dynamics (CFD)-derived hemodynamic metrics; however, this influence is not well-quantified, particularly in anomalous coronary anatomies. This study aims to evaluate how cardiac phase selection impacts CFD outcomes in normal and anomalous coronary arteries.

Methods: Multiphase CCTA datasets were analyzed from 40 patients: 30 with systolic and diastolic reconstructions (10 inter-arterial anomalous right coronary artery [ARCA], 10 myocardial bridging [MB], 10 normal) and 10 additional normals with mid-diastolic and diastolic reconstructions.

Key advances in cardiac computed tomography: A review of the most relevant studies published in 2024 on coronary and structural heart disease.

This review highlights the most relevant and influential studies on coronary and structural cardiac computed tomography published in 2024. The clinical utility of coronary CT angiography (CCTA) continues to expand, supported by advancements in quantitative plaque analysis, functional assessment through FFR-CT, and the integration of artificial intelligence (AI). Photon-counting CT has emerged as a promising technology for improving image quality and diagnostic accuracy.

The role of cardiac imaging in the post-ISCHEMIA world.

The last decade has seen a significant expansion of the evidence supporting the use of non-invasive imaging in the diagnosis of stable chest pain. The most significant of these was the ISCHEMIA trial which redefined the role of anatomical and functional imaging. The current paper examines this trial in the context of the wider literature, to bring together a review of the role of imaging in the patient with stable chest pain.

Regionally resolved cardiac metabolism using a dipole-loop array coil for 7 T P-MRSI.

Purpose: We introduce a novel commercial phosphorus-31 (P) dipole-loop array coil, describing the coil hardware and testing its performance on phantoms. We used this coil to assess cardiac metabolism per region in healthy volunteers.

Methods: B field maps were simulated and compared to maps measured with a set of CSI sequences with varying voltages.

A Pipeline for Automated Quality Control of Chest Radiographs.

This article presents a suite of quality control tools for chest radiographs based on traditional and artificial intelligence methods, developed and tested with data from 39 centers in seven countries.

Socioeconomic status, cardiovascular risk factors and coronary atherosclerosis: a SCOT-HEART trial analysis.

Aims: To investigate the relationship between socioeconomic status, plaque burden on coronary computed tomography angiography (CCTA), management and outcomes.

Methods: In a post-hoc analysis of a multicentre randomised control trial, we assessed associations between socioeconomic status and qualitative (stenosis, adverse plaque characteristics) and quantitative (total plaque, calcified plaque, non-calcified and low attenuation) CCTA plaque features and examined the interaction of socioeconomic status on cardiovascular outcomes.

Results: Socioeconomic status was available in 3948 participants of whom 1989 were randomised to CCTA and 1629 scans were suitable and available for quantitative plaque analysis.

Quality of Life Outcomes With a Risk-Based Precision Testing Strategy Versus Usual Testing in Stable Patients With Suspected Coronary Disease: Results From the PRECISE Randomized Trial.

Background: The PRECISE (Prospective Randomized Trial of the Optimal Evaluation of Cardiac Symptoms and Revascularization) trial compared an investigational precision diagnostic testing strategy (n=1057) with usual testing (n=1046) in patients with stable chest pain and suspected coronary artery disease. Quality of life (QOL) outcomes were a prespecified secondary end point.

Methods: We assessed QOL by structured interviews in all trial participants at baseline and 45 days, 6 months, and 12 months postrandomization.

Impact of diabetes mellitus on coronary artery plaque characteristics and outcomes in the SCOT-HEART trial.

Background: Diabetes mellitus is an established cardiovascular risk factor. We assessed the impact of diabetes mellitus on quantitative plaque and long-term outcomes in patients with and without diabetes mellitus in the Scottish COmputed Tomography of the HEART (SCOT-HEART) trial.

Methods: Coronary artery calcium (CAC) was assessed on non-contrast computed tomography (CT).

Imaging in chronic thromboembolic pulmonary disease: Current practice and advances.

Chronic thromboembolic pulmonary disease (CTEPD) with or without pulmonary hypertension (PH) occurs when thromboemboli in pulmonary arteries fail to resolve completely. Pulmonary artery obstructions due to chronic thrombi and secondary microvasculopathy can increase pulmonary arterial pressure and resistance leading to chronic thromboembolic PH (CTEPH). Mechanical interventions and/or PH medications can improve cardiopulmonary haemodynamic, alleviate symptoms, and decrease mortality risk.

A new business paradigm to make coronary CT angiography (CCTA) accessible to all.

Recently, the Centers for Medicare and Medicaid proposed a classification change that, if enacted, could double reimbursement for coronary CT angiography (CCTA) in the U.S. [1].

SCCT Health Policy and Advocacy Efforts.

Cardiac computed tomography has a growing presence in multiple guidelines supported by a growing evidence base as to its accuracy and impact on clinical outcomes. Despite this, dissemination into widespread routine clinical practice has been slow, largely restricted to large academic centers and urban settings. The reasons of this are multifactorial, but one of the most impactful of these reasons is undeniably reimbursement.

Using machine learning to predict carotid artery symptoms from CT angiography: A radiomics and deep learning approach.

Purpose: To assess radiomics and deep learning (DL) methods in identifying symptomatic Carotid Artery Disease (CAD) from carotid CT angiography (CTA) images. We further compare the performance of these novel methods to the conventional calcium score.

Methods: Carotid CT angiography (CTA) images from symptomatic patients (ischaemic stroke/transient ischaemic attack within the last 3 months) and asymptomatic patients were analysed.

Prognostic Value of Stress Perfusion Cardiac MRI in Cardiovascular Disease: A Systematic Review and Meta-Analysis of the Effects of the Scanner, Stress Agent, and Analysis Technique.

Purpose To perform a systematic review and meta-analysis to assess the prognostic value of stress perfusion cardiac MRI in predicting cardiovascular outcomes. Materials and Methods A systematic literature search from the inception of PubMed, Embase, Web of Science, and China National Knowledge Infrastructure until January 2023 was performed for articles that reported the prognosis of stress perfusion cardiac MRI in predicting cardiovascular outcomes. The quality of included studies was assessed using the Quality in Prognosis Studies tool.

ESR Essentials: imaging in stable chest pain - practice recommendations by ESCR.

Stable chest pain is a common symptom with multiple potential causes. Non-invasive imaging has an important role in diagnosis and guiding management through the assessment of coronary stenoses, atherosclerotic plaque, myocardial ischaemia or infarction, and cardiac function. Computed tomography (CT) provides the anatomical evaluation of coronary artery disease (CAD) with the assessment of stenosis, plaque type and plaque burden, with additional functional information available from CT fractional flow reserve (FFR) or CT myocardial perfusion imaging.

Pretranscatheter and Posttranscatheter Valve Planning with Computed Tomography.

The range of potential transcatheter solutions to valve disease is increasing, bringing treatment options to those in whom surgery confers prohibitively high risk. As the range of devices and their indications grow, so too will the demand for procedural planning. Computed tomography will continue to enable this growth through the provision of accurate device sizing and procedural risk assessment.