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Artificial intelligence in coronary artery calcium score: rationale, different approaches, and outcomes

2024/05/03 by Antonio Giulio Gennari, Alexia Rossi, Carlo N. De Cecco +6 · 1 voice · 1 citation
Engineering · Medicine · #Advanced X-ray and CT Imaging #Cardiac Imaging and Diagnostics #Cardiac, Anesthesia and Surgical Outcomes

paper · pdf · doi:10.1007/s10554-024-03080-4

openalex publication_date 2024/05/03 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/22

Abstract

Almost 35 years after its introduction, coronary artery calcium score (CACS) not only survived technological advances but became one of the cornerstones of contemporary cardiovascular imaging. Its simplicity and quantitative nature established it as one of the most robust approaches for atherosclerotic cardiovascular disease risk stratification in primary prevention and a powerful tool to guide therapeutic choices. Groundbreaking advances in computational models and computer power translated into a surge of artificial intelligence (AI)-based approaches directly or indirectly linked to CACS analysis. This review aims to provide essential knowledge on the AI-based techniques currently applied to CACS, setting the stage for a holistic analysis of the use of these techniques in coronary artery calcium imaging. While the focus of the review will be detailing the evidence, strengths, and limitations of end-to-end CACS algorithms in electrocardiography-gated and non-gated scans, the current role of deep-learning image reconstructions, segmentation techniques, and combined applications such as simultaneous coronary artery calcium and pulmonary nodule segmentation, will also be discussed.

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