{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T09:45:52Z","timestamp":1793785552849,"version":"4.6.1"},"reference-count":21,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,1,11]],"date-time":"2025-01-11T00:00:00Z","timestamp":1736553600000},"content-version":"unspecified","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100002129","name":"Heart Foundation","doi-asserted-by":"publisher","award":["03-007-2023-0068"],"award-info":[{"award-number":["03-007-2023-0068"]}],"id":[{"id":"10.13039\/100002129","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016405","name":"European Atherosclerosis Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016405","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2024,12,15]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Visual assessment of coronary CT angiography (CCTA) is time-consuming, influenced by reader experience and prone to interobserver variability. This study evaluated a novel algorithm for coronary stenosis quantification (atherosclerosis imaging quantitative CT, AI-QCT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study included 208 patients with suspected coronary artery disease (CAD) undergoing CCTA in Perfusion Imaging and CT Coronary Angiography With Invasive Coronary Angiography-1. AI-QCT and blinded readers assessed coronary artery stenosis following the Coronary Artery Disease Reporting and Data System consensus. Accuracy of AI-QCT was compared with a level 3 and two level 2 clinical readers against an invasive quantitative coronary angiography (QCA) reference standard (\u226550% stenosis) in an area under the curve (AUC) analysis, evaluated per-patient and per-vessel and stratified by plaque volume.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 208 patients with a mean age of 58\u00b19 years and 37% women, AI-QCT demonstrated superior concordance with QCA compared with clinical CCTA assessments. For the detection of obstructive stenosis (\u226550%), AI-QCT achieved an AUC of 0.91 on a per-patient level, outperforming level 3 (AUC 0.77; p&lt;0.002) and level 2 readers (AUC 0.79; p&lt;0.001 and AUC 0.76; p&lt;0.001). The advantage of AI-QCT was most prominent in those with above median plaque volume. At the per-vessel level, AI-QCT achieved an AUC of 0.86, similar to level 3 (AUC 0.82; p=0.098) stenosis, but superior to level 2 readers (both AUC 0.69; p&lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AI-QCT demonstrated superior agreement with invasive QCA compared to clinical CCTA assessments, particularly compared to level 2 readers in those with extensive CAD. Integrating AI-QCT into routine clinical practice holds promise for improving the accuracy of stenosis quantification through CCTA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/openhrt-2024-003115","type":"journal-article","created":{"date-parts":[[2025,1,12]],"date-time":"2025-01-12T00:00:24Z","timestamp":1736640024000},"page":"e003115","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":27,"title":["Diagnostic accuracy in coronary CT angiography analysis: artificial intelligence versus human assessment"],"prefix":"10.1136","volume":"12","clinical-trial-number":[{"clinical-trial-number":"nct01521468","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7139-6899","authenticated-orcid":false,"given":"Rachel","family":"Bernardo","sequence":"first","affiliation":[{"name":"Division of Cardiology and Department of Radiology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9045-6009","authenticated-orcid":false,"given":"Nick S","family":"Nurmohamed","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands"},{"name":"Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel J","family":"Bom","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3212-2665","authenticated-orcid":false,"given":"Ruurt","family":"Jukema","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruben W","family":"de Winter","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Sprengers","sequence":"additional","affiliation":[{"name":"Department of Radiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik S G","family":"Stroes","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James K","family":"Min","sequence":"additional","affiliation":[{"name":"Cleerly Inc, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Earls","sequence":"additional","affiliation":[{"name":"Cleerly Inc, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Danad","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew D","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Cardiology and Department of Radiology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Knaapen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the 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Impact of Atherosclerosis Imaging-Quantitative Computed Tomography on Diagnostic Certainty, Downstream Testing. 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