{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T22:11:25Z","timestamp":1793916685790,"version":"4.8.0"},"reference-count":73,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:00:00Z","timestamp":1760054400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:00:00Z","timestamp":1760054400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/100000002","name":"U.S. National Institutes of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"DOI":"10.1038\/s41598-025-19422-8","type":"journal-article","created":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T09:32:04Z","timestamp":1760088724000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["AI-based modality-agnostic classification system for vascular calcifications"],"prefix":"10.1038","volume":"15","author":[{"given":"Mehdi","family":"Ramezanpour","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne M.","family":"Robertson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasutaka","family":"Tobe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaowei","family":"Jia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan R.","family":"Cebral","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,10]]},"reference":[{"key":"19422_CR1","doi-asserted-by":"publisher","first-page":"2506","DOI":"10.1093\/cvr\/cvab273","volume":"117","author":"F Bartoli-Leonard","year":"2021","unstructured":"Bartoli-Leonard, F., Zimmer, J. & Aikawa, E. Innate and adaptive immunity: The understudied driving force of heart valve disease. Cardiovasc. Res. 117, 2506\u20132524. https:\/\/doi.org\/10.1093\/cvr\/cvab273 (2021).","journal-title":"Cardiovasc. Res."},{"key":"19422_CR2","doi-asserted-by":"publisher","first-page":"1386","DOI":"10.1177\/2047487320919895","volume":"28","author":"JW Bartstra","year":"2021","unstructured":"Bartstra, J. W., Mali, W. P. T. M., Spiering, W. & de Jong, P. A. Abdominal aortic calcification: From ancient friend to modern foe. Eur. J. Prev. Cardiol. 28, 1386\u20131391. https:\/\/doi.org\/10.1177\/2047487320919895 (2021).","journal-title":"Eur. J. Prev. Cardiol."},{"key":"19422_CR3","doi-asserted-by":"publisher","first-page":"2157","DOI":"10.1161\/ATVBAHA.119.312922","volume":"39","author":"PS Gade","year":"2019","unstructured":"Gade, P. S. et al. Calcification in human intracranial aneurysms is highly prevalent and displays both atherosclerotic and nonatherosclerotic types. Arterioscler. Thromb. Vasc. Biol. 39, 2157\u20132167. https:\/\/doi.org\/10.1161\/ATVBAHA.119.312922 (2019).","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"19422_CR4","doi-asserted-by":"publisher","first-page":"2915","DOI":"10.1113\/JP271339","volume":"594","author":"JL Ruiz","year":"2016","unstructured":"Ruiz, J. L., Weinbaum, S., Aikawa, E. & Hutcheson, J. D. Zooming in on the genesis of atherosclerotic plaque microcalcifications. J. Physiol. 594, 2915\u20132927. https:\/\/doi.org\/10.1113\/JP271339 (2016).","journal-title":"J. Physiol."},{"key":"19422_CR5","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.1019917","author":"A Corti","year":"2022","unstructured":"Corti, A. et al. The effect of plaque morphology, material composition and microcalcifications on the risk of cap rupture: A structural analysis of vulnerable atherosclerotic plaques. Front. Cardiovasc. Med. https:\/\/doi.org\/10.3389\/fcvm.2022.1019917 (2022).","journal-title":"Front. Cardiovasc. Med."},{"key":"19422_CR6","doi-asserted-by":"publisher","first-page":"10741","DOI":"10.1073\/pnas.1308814110","volume":"110","author":"A Kelly-Arnold","year":"2013","unstructured":"Kelly-Arnold, A. et al. Revised microcalcification hypothesis for fibrous cap rupture in human coronary arteries. Proc. Natl. Acad. Sci. U. S. A. 110, 10741\u201310746. https:\/\/doi.org\/10.1073\/pnas.1308814110 (2013).","journal-title":"Proc. Natl. Acad. Sci. U. S. A."},{"key":"19422_CR7","doi-asserted-by":"publisher","first-page":"e2202577119","DOI":"10.1073\/pnas.2202577119","volume":"119","author":"E The","year":"2022","unstructured":"The, E. et al. Interleukin 38 alleviates aortic valve calcification by inhibition of NLRP3. Proc. Natl. Acad. Sci. 119, e2202577119. https:\/\/doi.org\/10.1073\/pnas.2202577119 (2022).","journal-title":"Proc. Natl. Acad. Sci."},{"key":"19422_CR8","doi-asserted-by":"publisher","first-page":"56","DOI":"10.3389\/fphys.2020.00056","volume":"11","author":"X Shi","year":"2020","unstructured":"Shi, X. et al. Calcification in atherosclerotic plaque vulnerability: Friend or foe?. Front. Physiol. 11, 56. https:\/\/doi.org\/10.3389\/fphys.2020.00056 (2020).","journal-title":"Front. Physiol."},{"key":"19422_CR9","first-page":"37","volume":"5","author":"Y Vengrenyuk","year":"2008","unstructured":"Vengrenyuk, Y., Cardoso, L. & Weinbaum, S. Micro-CT based analysis of a new paradigm for vulnerable plaque rupture: Cellular microcalcifications in fibrous caps. Mol. Cell. Biomech. 5, 37\u201347 (2008).","journal-title":"Mol. Cell. Biomech."},{"key":"19422_CR10","doi-asserted-by":"publisher","first-page":"1915","DOI":"10.1007\/s00380-016-0820-3","volume":"31","author":"M Sakaguchi","year":"2016","unstructured":"Sakaguchi, M. et al. New insights into spotty calcification and plaque rupture in acute coronary syndrome: An optical coherence tomography study. Heart Vess. 31, 1915\u20131922. https:\/\/doi.org\/10.1007\/s00380-016-0820-3 (2016).","journal-title":"Heart Vess."},{"key":"19422_CR11","doi-asserted-by":"publisher","first-page":"S73","DOI":"10.1016\/j.jacc.2016.03.201","volume":"67","author":"J Pu","year":"2016","unstructured":"Pu, J. et al. TCTAP A-165 calcification pattern and plaque vulnerability: Lessons from in-vivo and in-vitro multimodality intracoronary imaging studies. J. Am. Coll. Cardiol. 67, S73. https:\/\/doi.org\/10.1016\/j.jacc.2016.03.201 (2016).","journal-title":"J. Am. Coll. Cardiol."},{"key":"19422_CR12","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1007\/s00392-018-1243-1","volume":"107","author":"S Reith","year":"2018","unstructured":"Reith, S., Milzi, A., Dettori, R., Marx, N. & Burgmaier, M. Predictors for target lesion microcalcifications in patients with stable coronary artery disease: An optical coherence tomography study. Clin. Res. Cardiol. 107, 763\u2013771. https:\/\/doi.org\/10.1007\/s00392-018-1243-1 (2018).","journal-title":"Clin. Res. Cardiol."},{"key":"19422_CR13","doi-asserted-by":"publisher","first-page":"S4","DOI":"10.1016\/j.jcin.2015.12.039","volume":"9","author":"J Pu","year":"2016","unstructured":"Pu, J., Zhang, P., Jun, G., Shang, Y. & He, B. CRT-200.07 spotty calcium location plays a key role in human plaque instability: insights from studies in vivo from cardiac arrest survivors and in vitro from autopsied sudden cardiac death victims. JACC Cardiovasc Interv. 9, S4\u2013S4. https:\/\/doi.org\/10.1016\/j.jcin.2015.12.039 (2016).","journal-title":"JACC Cardiovasc Interv."},{"key":"19422_CR14","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1016\/j.ejvs.2006.02.019","volume":"32","author":"M Miralles","year":"2006","unstructured":"Miralles, M. et al. Quantification and characterization of carotid calcium with multi-detector CT-angiography. Eur. J. Vasc. Endovasc. Surg. 32, 561\u2013567. https:\/\/doi.org\/10.1016\/j.ejvs.2006.02.019 (2006).","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"19422_CR15","doi-asserted-by":"publisher","first-page":"1341","DOI":"10.1016\/j.jstrokecerebrovasdis.2015.02.010","volume":"24","author":"H Katano","year":"2015","unstructured":"Katano, H., Mase, M., Nishikawa, Y. & Yamada, K. Calcified carotid plaques show double symptomatic peaks according to Agatston calcium score. J. Stroke Cerebrovasc. Dis. 24, 1341\u20131350. https:\/\/doi.org\/10.1016\/j.jstrokecerebrovasdis.2015.02.010 (2015).","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"19422_CR16","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1016\/j.jbiomech.2014.01.011","volume":"47","author":"GA Holzapfel","year":"2014","unstructured":"Holzapfel, G. A., Mulvihill, J. J., Cunnane, E. M. & Walsh, M. T. Computational approaches for analyzing the mechanics of atherosclerotic plaques: A review. J. Biomech. 47, 859\u2013869. https:\/\/doi.org\/10.1016\/j.jbiomech.2014.01.011 (2014).","journal-title":"J. Biomech."},{"key":"19422_CR17","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1016\/j.carpath.2015.03.002","volume":"24","author":"JL Ruiz","year":"2015","unstructured":"Ruiz, J. L., Hutcheson, J. D. & Aikawa, E. Cardiovascular calcification: Current controversies and novel concepts. Cardiovasc. Pathol. 24, 207\u2013212. https:\/\/doi.org\/10.1016\/j.carpath.2015.03.002 (2015).","journal-title":"Cardiovasc. Pathol."},{"key":"19422_CR18","doi-asserted-by":"publisher","first-page":"14678","DOI":"10.1073\/pnas.0606310103","volume":"103","author":"Y Vengrenyuk","year":"2006","unstructured":"Vengrenyuk, Y. et al. A hypothesis for vulnerable plaque rupture due to stress-induced debonding around cellular microcalcifications in thin fibrous caps. Proc. Natl. Acad. Sci. 103, 14678\u201314683. https:\/\/doi.org\/10.1073\/pnas.0606310103 (2006).","journal-title":"Proc. Natl. Acad. Sci."},{"issue":"Suppl 1","key":"19422_CR19","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1007\/s10554-009-9578-3","volume":"26","author":"X Xu","year":"2010","unstructured":"Xu, X. et al. High-resolution MR study of the relationship between superficial calcification and the stability of carotid atherosclerotic plaque. Int. J. Cardiovasc. Imaging 26(Suppl 1), 143\u2013150. https:\/\/doi.org\/10.1007\/s10554-009-9578-3 (2010).","journal-title":"Int. J. Cardiovasc. Imaging"},{"key":"19422_CR20","doi-asserted-by":"publisher","first-page":"4968","DOI":"10.1007\/s00330-018-5535-7","volume":"28","author":"J Yang","year":"2018","unstructured":"Yang, J. et al. Superficial and multiple calcifications and ulceration associate with intraplaque hemorrhage in the carotid atherosclerotic plaque. Eur. Radiol. 28, 4968\u20134977. https:\/\/doi.org\/10.1007\/s00330-018-5535-7 (2018).","journal-title":"Eur. Radiol."},{"key":"19422_CR21","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1007\/s11340-020-00657-7","volume":"61","author":"RN Fortunato","year":"2021","unstructured":"Fortunato, R. N., Robertson, A. M., Sang, C., Duan, X. & Maiti, S. Effect of macro-calcification on the failure mechanics of intracranial aneurysmal wall tissue. Exp. Mech. 61, 5\u201318. https:\/\/doi.org\/10.1007\/s11340-020-00657-7 (2021).","journal-title":"Exp. Mech."},{"key":"19422_CR22","doi-asserted-by":"publisher","first-page":"1228","DOI":"10.1161\/ATVBAHA.116.308360","volume":"37","author":"R Lin","year":"2017","unstructured":"Lin, R., Chen, S., Liu, G., Xue, Y. & Zhao, X. Association between carotid atherosclerotic plaque calcification and intraplaque hemorrhage. Arterioscler. Thromb. Vasc. Biol. 37, 1228\u20131233. https:\/\/doi.org\/10.1161\/ATVBAHA.116.308360 (2017).","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"19422_CR23","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1016\/j.cjca.2017.05.003","volume":"33","author":"Y Zhan","year":"2017","unstructured":"Zhan, Y., Zhang, Y., Hou, J., Lin, G. & Yu, B. Relation between superficial calcifications and plaque rupture: An optical coherence tomography study. Can. J. Cardiol. 33, 991\u2013997. https:\/\/doi.org\/10.1016\/j.cjca.2017.05.003 (2017).","journal-title":"Can. J. Cardiol."},{"key":"19422_CR24","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1038\/nmat4519","volume":"15","author":"JD Hutcheson","year":"2016","unstructured":"Hutcheson, J. D. et al. Genesis and growth of extracellular-vesicle-derived microcalcification in atherosclerotic plaques. Nat. Mater. 15, 335\u2013343. https:\/\/doi.org\/10.1038\/nmat4519 (2016).","journal-title":"Nat. Mater."},{"key":"19422_CR25","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1016\/j.amjcard.2005.03.074","volume":"96","author":"K Fujii","year":"2005","unstructured":"Fujii, K. et al. Intravascular ultrasound study of patterns of calcium in ruptured coronary plaques. Am. J. Cardiol. 96, 352\u2013357. https:\/\/doi.org\/10.1016\/j.amjcard.2005.03.074 (2005).","journal-title":"Am. J. Cardiol."},{"key":"19422_CR26","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.amjcard.2013.02.048","volume":"112","author":"M Mizukoshi","year":"2013","unstructured":"Mizukoshi, M. et al. Coronary superficial and spotty calcium deposits in culprit coronary lesions of acute coronary syndrome as determined by optical coherence tomography. Am. J. Cardiol. 112, 34\u201340. https:\/\/doi.org\/10.1016\/j.amjcard.2013.02.048 (2013).","journal-title":"Am. J. Cardiol."},{"key":"19422_CR27","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1159\/000381138","volume":"39","author":"QJ van den Bouwhuijsen","year":"2015","unstructured":"van den Bouwhuijsen, Q. J. et al. Coexistence of calcification, intraplaque hemorrhage and lipid core within the asymptomatic atherosclerotic carotid plaque: The Rotterdam study. Cerebrovasc. Dis. 39, 319\u2013324. https:\/\/doi.org\/10.1159\/000381138 (2015).","journal-title":"Cerebrovasc. Dis."},{"key":"19422_CR28","doi-asserted-by":"publisher","first-page":"402","DOI":"10.3174\/ajnr.A3228","volume":"34","author":"R Magge","year":"2013","unstructured":"Magge, R. et al. Clinical risk factors and CT imaging features of carotid atherosclerotic plaques as predictors of new incident carotid ischemic stroke: A retrospective cohort study. AJNR Am. J. Neuroradiol. 34, 402\u2013409. https:\/\/doi.org\/10.3174\/ajnr.A3228 (2013).","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"19422_CR29","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1001\/jamainternmed.2022.1262","volume":"182","author":"KJL Bell","year":"2022","unstructured":"Bell, K. J. L. et al. Evaluation of the incremental value of a coronary artery calcium score beyond traditional cardiovascular risk assessment: A systematic review and meta-analysis. JAMA Intern. Med. 182, 634\u2013642. https:\/\/doi.org\/10.1001\/jamainternmed.2022.1262 (2022).","journal-title":"JAMA Intern. Med."},{"key":"19422_CR30","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1001\/jamacardio.2021.4406","volume":"7","author":"MB Mortensen","year":"2022","unstructured":"Mortensen, M. B. et al. Association of age with the diagnostic value of coronary artery calcium score for ruling out coronary stenosis in symptomatic patients. JAMA Cardiol. 7, 36\u201344. https:\/\/doi.org\/10.1001\/jamacardio.2021.4406 (2022).","journal-title":"JAMA Cardiol."},{"key":"19422_CR31","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1001\/jamacardio.2019.5315","volume":"5","author":"AR van Rosendael","year":"2020","unstructured":"van Rosendael, A. R. et al. Association of high-density calcified 1K plaque with risk of acute coronary syndrome. JAMA Cardiol. 5, 282\u2013290. https:\/\/doi.org\/10.1001\/jamacardio.2019.5315 (2020).","journal-title":"JAMA Cardiol."},{"key":"19422_CR32","doi-asserted-by":"publisher","first-page":"2533","DOI":"10.1016\/j.jacc.2011.10.851","volume":"58","author":"C Villines Todd","year":"2011","unstructured":"Villines Todd, C. et al. Prevalence and severity of coronary artery disease and adverse events among symptomatic patients with coronary artery calcification scores of zero undergoing coronary computed tomography angiography. J. Am. Coll. Cardiol. 58, 2533\u20132540. https:\/\/doi.org\/10.1016\/j.jacc.2011.10.851 (2011).","journal-title":"J. Am. Coll. Cardiol."},{"key":"19422_CR33","doi-asserted-by":"publisher","first-page":"536","DOI":"10.1186\/s12872-022-02956-4","volume":"22","author":"Y Zhao","year":"2022","unstructured":"Zhao, Y. et al. Coronary calcium density in relation to coronary heart disease and cardiovascular disease in adults with diabetes or metabolic syndrome: The multi-ethnic study of atherosclerosis (MESA). BMC Cardiovasc. Disord. 22, 536. https:\/\/doi.org\/10.1186\/s12872-022-02956-4 (2022).","journal-title":"BMC Cardiovasc. Disord."},{"key":"19422_CR34","doi-asserted-by":"publisher","first-page":"947","DOI":"10.1148\/rg.210122","volume":"42","author":"A Gupta","year":"2022","unstructured":"Gupta, A. et al. Coronary artery calcium scoring: Current status and future directions. Radiographics 42, 947\u2013967. https:\/\/doi.org\/10.1148\/rg.210122 (2022).","journal-title":"Radiographics"},{"key":"19422_CR35","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1016\/j.jacc.2015.01.036","volume":"65","author":"R Puri","year":"2015","unstructured":"Puri, R. et al. Impact of statins on serial coronary calcification during atheroma progression and regression. J. Am. Coll. Cardiol. 65, 1273\u20131282. https:\/\/doi.org\/10.1016\/j.jacc.2015.01.036 (2015).","journal-title":"J. Am. Coll. Cardiol."},{"key":"19422_CR36","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.atherosclerosis.2020.10.009","volume":"316","author":"AD Osei","year":"2021","unstructured":"Osei, A. D. et al. Prognostic value of coronary artery calcium score, area, and density among individuals on statin therapy versus non-users: The coronary artery calcium consortium. Atherosclerosis 316, 79\u201383. https:\/\/doi.org\/10.1016\/j.atherosclerosis.2020.10.009 (2021).","journal-title":"Atherosclerosis"},{"key":"19422_CR37","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1038\/s41571-019-0253-x","volume":"16","author":"J Brierley","year":"2019","unstructured":"Brierley, J. et al. Global consultation on cancer staging: Promoting consistent understanding and use. Nat. Rev. Clin. Oncol. 16, 763\u2013771. https:\/\/doi.org\/10.1038\/s41571-019-0253-x (2019).","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"19422_CR38","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1038\/modpathol.3800054","volume":"17","author":"PA Humphrey","year":"2004","unstructured":"Humphrey, P. A. Gleason grading and prognostic factors in carcinoma of the prostate. Mod. Pathol. 17, 292\u2013306. https:\/\/doi.org\/10.1038\/modpathol.3800054 (2004).","journal-title":"Mod. Pathol."},{"key":"19422_CR39","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1159\/000477556","volume":"61","author":"R Nayar","year":"2017","unstructured":"Nayar, R. & Wilbur, D. C. The bethesda system for reporting cervical cytology: a Historical perspective. Acta Cytol. 61, 359\u2013372. https:\/\/doi.org\/10.1159\/000477556 (2017).","journal-title":"Acta Cytol."},{"key":"19422_CR40","doi-asserted-by":"publisher","first-page":"1078","DOI":"10.1161\/ATVBAHA.120.313131","volume":"40","author":"Y Chen","year":"2020","unstructured":"Chen, Y., Zhao, X. & Wu, H. Arterial stiffness. Arterioscler. Thromb. Vasc. Biol. 40, 1078\u20131093. https:\/\/doi.org\/10.1161\/ATVBAHA.120.313131 (2020).","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"19422_CR41","doi-asserted-by":"publisher","first-page":"12906","DOI":"10.3390\/ijms232112906","volume":"23","author":"MY Henein","year":"2022","unstructured":"Henein, M. Y., Vancheri, S., Longo, G. & Vancheri, F. The role of inflammation in cardiovascular disease. Int. J. Mol. Sci. 23, 12906 (2022).","journal-title":"Int. J. Mol. Sci."},{"key":"19422_CR42","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1097\/mol.0000000000000105","volume":"25","author":"JD Hutcheson","year":"2014","unstructured":"Hutcheson, J. D., Maldonado, N. & Aikawa, E. Small entities with large impact: Microcalcifications and atherosclerotic plaque vulnerability. Curr. Opin. Lipidol. 25, 327\u2013332. https:\/\/doi.org\/10.1097\/mol.0000000000000105 (2014).","journal-title":"Curr. Opin. Lipidol."},{"key":"19422_CR43","doi-asserted-by":"publisher","first-page":"5694","DOI":"10.3390\/ijms20225694","volume":"20","author":"A Jaminon","year":"2019","unstructured":"Jaminon, A., Reesink, K., Kroon, A. & Schurgers, L. The role of vascular smooth muscle cells in arterial remodeling: Focus on calcification-related processes. Int. J. Mol. Sci. 20, 5694 (2019).","journal-title":"Int. J. Mol. Sci."},{"key":"19422_CR44","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.atherosclerosis.2020.05.017","volume":"306","author":"H Jinnouchi","year":"2020","unstructured":"Jinnouchi, H. et al. Calcium deposition within coronary atherosclerotic lesion: Implications for plaque stability. Atherosclerosis 306, 85\u201395. https:\/\/doi.org\/10.1016\/j.atherosclerosis.2020.05.017 (2020).","journal-title":"Atherosclerosis"},{"key":"19422_CR45","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/j.jcmg.2017.10.012","volume":"11","author":"H Mori","year":"2018","unstructured":"Mori, H. et al. Coronary artery calcification and its progression. JACC Cardiovasc. Imaging 11, 127\u2013142. https:\/\/doi.org\/10.1016\/j.jcmg.2017.10.012 (2018).","journal-title":"JACC Cardiovasc. Imaging"},{"key":"19422_CR46","doi-asserted-by":"publisher","first-page":"1835","DOI":"10.1016\/j.jcmg.2019.01.045","volume":"12","author":"T Pawade","year":"2019","unstructured":"Pawade, T., Sheth, T., Guzzetti, E., Dweck Marc, R. & Clavel, M.-A. Why and how to measure aortic valve calcification in patients with aortic stenosis. JACC Cardiovasc. Imaging 12, 1835\u20131848. https:\/\/doi.org\/10.1016\/j.jcmg.2019.01.045 (2019).","journal-title":"JACC Cardiovasc. Imaging"},{"key":"19422_CR47","doi-asserted-by":"publisher","first-page":"114052","DOI":"10.1016\/j.expneurol.2022.114052","volume":"353","author":"R Rahmani","year":"2022","unstructured":"Rahmani, R., Baranoski, J. F., Albuquerque, F. C., Lawton, M. T. & Hashimoto, T. Intracranial aneurysm calcification: A narrative review. Exp. Neurol. 353, 114052. https:\/\/doi.org\/10.1016\/j.expneurol.2022.114052 (2022).","journal-title":"Exp. Neurol."},{"key":"19422_CR48","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2020.00056","author":"X Shi","year":"2020","unstructured":"Shi, X. et al. Calcification in atherosclerotic plaque vulnerability: Friend or foe?. Front. Physiol. https:\/\/doi.org\/10.3389\/fphys.2020.00056 (2020).","journal-title":"Front. Physiol."},{"key":"19422_CR49","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1016\/j.jcin.2018.12.013","volume":"12","author":"T Sugiyama","year":"2019","unstructured":"Sugiyama, T. et al. Calcified Plaques in patients with acute coronary syndromes. JACC: Cardiovasc. Interv. 12, 531\u2013540. https:\/\/doi.org\/10.1016\/j.jcin.2018.12.013 (2019).","journal-title":"JACC: Cardiovasc. Interv."},{"key":"19422_CR50","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.atherosclerosis.2020.07.011","volume":"309","author":"D Han","year":"2020","unstructured":"Han, D. et al. Prognostic significance of subtle coronary calcification in patients with zero coronary artery calcium score: From the CONFIRM registry. Atherosclerosis 309, 33\u201338. https:\/\/doi.org\/10.1016\/j.atherosclerosis.2020.07.011 (2020).","journal-title":"Atherosclerosis"},{"key":"19422_CR51","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jbiomech.2019.03.005","volume":"87","author":"HE Barrett","year":"2019","unstructured":"Barrett, H. E., Van der Heiden, K., Farrell, E., Gijsen, F. J. H. & Akyildiz, A. C. Calcifications in atherosclerotic plaques and impact on plaque biomechanics. J. Biomech. 87, 1\u201312. https:\/\/doi.org\/10.1016\/j.jbiomech.2019.03.005 (2019).","journal-title":"J. Biomech."},{"key":"19422_CR52","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1016\/j.atherosclerosis.2020.08.022","volume":"311","author":"AR van Rosendael","year":"2020","unstructured":"van Rosendael, A. R., Cainzos-Achirica, M. & Al-Mallah, M. H. Calcified plaque morphology, density, and risk. Atherosclerosis 311, 100\u2013102. https:\/\/doi.org\/10.1016\/j.atherosclerosis.2020.08.022 (2020).","journal-title":"Atherosclerosis"},{"key":"19422_CR53","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.1016\/j.jbiomech.2007.11.029","volume":"41","author":"D Bluestein","year":"2008","unstructured":"Bluestein, D. et al. Influence of microcalcifications on vulnerable plaque mechanics using FSI modeling. J. Biomech. 41, 1111\u20131118. https:\/\/doi.org\/10.1016\/j.jbiomech.2007.11.029 (2008).","journal-title":"J. Biomech."},{"key":"19422_CR54","doi-asserted-by":"publisher","first-page":"H619","DOI":"10.1152\/ajpheart.00036.2012","volume":"303","author":"N Maldonado","year":"2012","unstructured":"Maldonado, N. et al. A mechanistic analysis of the role of microcalcifications in atherosclerotic plaque stability: Potential implications for plaque rupture. Am. J. Physiol.-Heart Circulat. Physiol. 303, H619\u2013H628. https:\/\/doi.org\/10.1152\/ajpheart.00036.2012 (2012).","journal-title":"Am. J. Physiol.-Heart Circulat. Physiol."},{"key":"19422_CR55","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.3390\/tomography8030108","volume":"8","author":"HJ Carpenter","year":"2022","unstructured":"Carpenter, H. J. et al. Automated coronary optical coherence tomography feature extraction with application to three-dimensional reconstruction. Tomography 8, 1307\u20131349 (2022).","journal-title":"Tomography"},{"key":"19422_CR56","doi-asserted-by":"publisher","DOI":"10.1117\/12.2515256","author":"Y Gharaibeh","year":"2019","unstructured":"Gharaibeh, Y. et al. Deep learning segmentation of coronary calcified plaque from intravascular optical coherence tomography (IVOCT) images with application to finite element modeling of stent deployment. Proc. SPIE Int. Soc. Opt. Eng. https:\/\/doi.org\/10.1117\/12.2515256 (2019).","journal-title":"Proc. SPIE Int. Soc. Opt. Eng."},{"key":"19422_CR57","doi-asserted-by":"publisher","first-page":"1719","DOI":"10.1364\/BOE.514673","volume":"15","author":"M Haft-Javaherian","year":"2024","unstructured":"Haft-Javaherian, M. et al. Segmentation of anatomical layers and imaging artifacts in intravascular polarization sensitive optical coherence tomography using attending physician and boundary cardinality losses. Biomed. Opt. Express 15, 1719\u20131738. https:\/\/doi.org\/10.1364\/BOE.514673 (2024).","journal-title":"Biomed. Opt. Express"},{"key":"19422_CR58","doi-asserted-by":"publisher","first-page":"1168","DOI":"10.1109\/jbhi.2017.2762520","volume":"22","author":"L Athanasiou","year":"2018","unstructured":"Athanasiou, L. et al. Optimized computer-aided segmentation and three-dimensional reconstruction using intracoronary optical coherence tomography. IEEE J. Biomed. Health Inform. 22, 1168\u20131176. https:\/\/doi.org\/10.1109\/jbhi.2017.2762520 (2018).","journal-title":"IEEE J. Biomed. Health Inform."},{"key":"19422_CR59","doi-asserted-by":"publisher","first-page":"045002","DOI":"10.1117\/1.Jmi.6.4.045002","volume":"6","author":"Y Gharaibeh","year":"2019","unstructured":"Gharaibeh, Y. et al. Coronary calcification segmentation in intravascular OCT images using deep learning: Application to calcification scoring. J. Med. Imaging (Bellingham) 6, 045002. https:\/\/doi.org\/10.1117\/1.Jmi.6.4.045002 (2019).","journal-title":"J. Med. Imaging (Bellingham)"},{"key":"19422_CR60","doi-asserted-by":"publisher","DOI":"10.1016\/j.jscai.2024.102524","author":"P Young","year":"2025","unstructured":"Young, P. et al. Histology-grounded automated plaque subtype segmentation in intravascular optical coherence tomography. J. Soc. Cardiovasc. Angiogr. Interv. https:\/\/doi.org\/10.1016\/j.jscai.2024.102524 (2025).","journal-title":"J. Soc. Cardiovasc. Angiogr. Interv."},{"key":"19422_CR61","doi-asserted-by":"publisher","first-page":"13031","DOI":"10.1038\/s41598-023-40257-8","volume":"13","author":"W Wu","year":"2023","unstructured":"Wu, W. et al. 3D reconstruction of coronary artery bifurcations from intravascular ultrasound and angiography. Sci. Rep. 13, 13031. https:\/\/doi.org\/10.1038\/s41598-023-40257-8 (2023).","journal-title":"Sci. Rep."},{"key":"19422_CR62","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1016\/0735-1097(90)90282-t","volume":"15","author":"AS Agatston","year":"1990","unstructured":"Agatston, A. S. et al. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15, 827\u2013832. https:\/\/doi.org\/10.1016\/0735-1097(90)90282-t (1990).","journal-title":"J Am Coll Cardiol"},{"key":"19422_CR63","doi-asserted-by":"publisher","first-page":"e231956","DOI":"10.1148\/radiol.231956","volume":"310","author":"MC Halfmann","year":"2024","unstructured":"Halfmann, M. C. et al. Ultrahigh-Spatial-resolution photon-counting detector CT angiography of coronary artery disease for stenosis assessment. Radiology 310, e231956. https:\/\/doi.org\/10.1148\/radiol.231956 (2024).","journal-title":"Radiology"},{"key":"19422_CR64","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2021.613400","author":"K Nishimiya","year":"2021","unstructured":"Nishimiya, K. & Tearney, G. Micro optical coherence tomography for coronary imaging. Front. Cardiovasc. Med. https:\/\/doi.org\/10.3389\/fcvm.2021.613400 (2021).","journal-title":"Front. Cardiovasc. Med."},{"key":"19422_CR65","doi-asserted-by":"publisher","first-page":"9248","DOI":"10.1038\/s41598-020-65742-2","volume":"10","author":"J Kim","year":"2020","unstructured":"Kim, J. et al. Flexible endoscopic micro-optical coherence tomography for three-dimensional imaging of the arterial microstructure. Sci. Rep. 10, 9248. https:\/\/doi.org\/10.1038\/s41598-020-65742-2 (2020).","journal-title":"Sci. Rep."},{"key":"19422_CR66","doi-asserted-by":"publisher","first-page":"2629","DOI":"10.1038\/s41598-019-39639-8","volume":"9","author":"SR Karamched","year":"2019","unstructured":"Karamched, S. R., Nosoudi, N., Moreland, H. E., Chowdhury, A. & Vyavahare, N. R. Site-specific chelation therapy with EDTA-loaded albumin nanoparticles reverses arterial calcification in a rat model of chronic kidney disease. Sci. Rep. 9, 2629. https:\/\/doi.org\/10.1038\/s41598-019-39639-8 (2019).","journal-title":"Sci. Rep."},{"key":"19422_CR67","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1161\/circresaha.116.310060","volume":"120","author":"JD Hutcheson","year":"2017","unstructured":"Hutcheson, J. D., Blaser, M. C. & Aikawa, E. Giving calcification its due: Recognition of a diverse disease: A first attempt to standardize the field. Circ. Res. 120, 270\u2013273. https:\/\/doi.org\/10.1161\/circresaha.116.310060 (2017).","journal-title":"Circ. Res."},{"key":"19422_CR68","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1016\/j.ejvs.2021.01.012","volume":"61","author":"S Kuntz","year":"2021","unstructured":"Kuntz, S. et al. Automated histological segmentation on micro computed tomography images of atherosclerotic arteries. Eur. J. Vasc. Endovasc. Surg. 61, 714\u2013715. https:\/\/doi.org\/10.1016\/j.ejvs.2021.01.012 (2021).","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"19422_CR69","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1007\/BF01589116","volume":"45","author":"DC Liu","year":"1989","unstructured":"Liu, D. C. & Nocedal, J. On the limited memory BFGS method for large scale optimization. Math. Program. 45, 503\u2013528. https:\/\/doi.org\/10.1007\/BF01589116 (1989).","journal-title":"Math. Program."},{"key":"19422_CR70","doi-asserted-by":"publisher","first-page":"11014","DOI":"10.1038\/s41598-018-29344-3","volume":"8","author":"W V\u00e5gberg","year":"2018","unstructured":"V\u00e5gberg, W., Persson, J., Szekely, L. & Hertz, H. M. Cellular-resolution 3D virtual histology of human coronary arteries using x-ray phase tomography. Sci. Rep. 8, 11014. https:\/\/doi.org\/10.1038\/s41598-018-29344-3 (2018).","journal-title":"Sci. Rep."},{"key":"19422_CR71","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.1007\/s00429-021-02231-w","volume":"226","author":"AC Trutti","year":"2021","unstructured":"Trutti, A. C. et al. A probabilistic atlas of the human ventral tegmental area (VTA) based on 7 Tesla MRI data. Brain Struct. Funct. 226, 1155\u20131167. https:\/\/doi.org\/10.1007\/s00429-021-02231-w (2021).","journal-title":"Brain Struct. Funct."},{"key":"19422_CR72","doi-asserted-by":"publisher","first-page":"229","DOI":"10.2217\/iim.12.13","volume":"4","author":"FE Boas","year":"2012","unstructured":"Boas, F. E. & Fleischmann, D. CT artifacts: Causes and reduction techniques. Imaging Med. 4, 229\u2013240 (2012).","journal-title":"Imaging Med."},{"key":"19422_CR73","unstructured":"Ester, M., Kriegel, H.-P., Sander, J. & Xu, X. in Proceedings of the Second International Conference on Knowledge Discovery and Data Mining 226\u2013231 (AAAI Press, Portland, Oregon, 1996)."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-19422-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-19422-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-19422-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T09:32:07Z","timestamp":1760088727000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-19422-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,10]]},"references-count":73,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["19422"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-19422-8","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,10]]},"assertion":[{"value":"8 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 September 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 October 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"M. Ramezanpour (the first author) and A.M. Robertson (the corresponding author) are inventors on a pending international patent application (PCT\/US25\/10448) with U.S. Provisional Application No.: 63\/620,135, filed through the University of Pittsburgh Innovation Institute, related to the AI-driven classification system for vascular calcifications described in this manuscript. The rights to this invention have been assigned to the University of Pittsburgh. The remaining authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"35500"}}