IMR Press / RCM / Volume 25 / Issue 1 / DOI: 10.31083/j.rcm2501027
Open Access Review
Advances in Artificial Intelligence-Assisted Coronary Computed Tomographic Angiography for Atherosclerotic Plaque Characterization
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1 Department of Radiology, Nanjing First Hospital, Nanjing Medical University, 210006 Nanjing, Jiangsu, China
2 Department of Radiology, Jinling Hospital, Medical School of Nanjing University, 210002 Nanjing, Jiangsu, China
3 Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, 210006 Nanjing, Jiangsu, China
*Correspondence: xuhuillxhp@163.com (Hui Xu); kevinzhlj@163.com (Long Jiang Zhang)
These authors contributed equally.
Rev. Cardiovasc. Med. 2024, 25(1), 27; https://doi.org/10.31083/j.rcm2501027
Submitted: 8 July 2023 | Revised: 1 September 2023 | Accepted: 13 September 2023 | Published: 15 January 2024
(This article belongs to the Section Cardiovascular Imaging)
Copyright: © 2024 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Coronary artery disease is a leading cause of death worldwide. Major adverse cardiac events are associated not only with coronary luminal stenosis but also with atherosclerotic plaque components. Coronary computed tomography angiography (CCTA) enables non-invasive evaluation of atherosclerotic plaque along the entire coronary tree. However, precise and efficient assessment of plaque features on CCTA is still a challenge for physicians in daily practice. Artificial intelligence (AI) refers to algorithms that can simulate intelligent human behavior to improve clinical work efficiency. Recently, cardiovascular imaging has seen remarkable advancements with the use of AI. AI-assisted CCTA has the potential to facilitate the clinical workflow, offer objective and repeatable quantitative results, accelerate the interpretation of reports, and guide subsequent treatment. Several AI algorithms have been developed to provide a comprehensive assessment of atherosclerotic plaques. This review serves to highlight the cutting-edge applications of AI-assisted CCTA in atherosclerosis plaque characterization, including detecting obstructive plaques, assessing plaque volumes and vulnerability, monitoring plaque progression, and providing risk assessment. Finally, this paper discusses the current problems and future directions for implementing AI in real-world clinical settings.

Keywords
artificial intelligence
coronary CT angiography
coronary plaque
deep learning
Funding
BE2020699/Jiangsu Province Key Project of Comprehensive Prevention and Control of Chronic Diseases
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