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Purpose of Review <p>This scoping review explores recent advancements in coronary computed tomography angiography (CCTA) and its expanding role in the diagnosis and prognosis of atherosclerosis. Emphasis is placed on innovations in imaging technology, novel biomarkers, and artificial intelligence (AI) applications. We assess the clinical efficacy of these developments and explore future research directions.</p> Recent Findings <p>Key advancements in CCTA include photon-counting CT (PCCT), which enhances spatial resolution and plaque characterization, AI-enabled CT-based Quantitative Coronary Topography (AI-QCT), and AI-driven risk prediction models. Emerging biomarkers, such as the perivascular fat attenuation index (pFAI), provide novel insights into vascular inflammation, previously assessed only via serum biomarkers. Studies demonstrate CCTA’s prognostic utility in refining risk stratification, guiding therapeutic decisions, and minimizing unnecessary invasive procedures.</p> Summary <p>CCTA has become a key tool for anatomical and functional assessment as well as risk prediction in CAD. Future research should focus on AI validation, cost-effectiveness, and imaging integration to advance precision cardiovascular care.</p>

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Advancements in Coronary CT Angiography: Innovations in Diagnosis, Risk Stratification, and Prognosis in Atherosclerosis

  • 期刊论文

  • 发表日期：

    2025年4月14日

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  • Kyvan Irannejad,
  • Srikanth Krishnan,
  • Beshoy Iskander,
  • Soumya Kambalapalli,
  • Natdanai Punanithinont,
  • Keishi Ichikawa,
  • Suvasini Lakshmanan,
  • Matthew J. Budoff

摘要

Purpose of Review

This scoping review explores recent advancements in coronary computed tomography angiography (CCTA) and its expanding role in the diagnosis and prognosis of atherosclerosis. Emphasis is placed on innovations in imaging technology, novel biomarkers, and artificial intelligence (AI) applications. We assess the clinical efficacy of these developments and explore future research directions.

Recent Findings

Key advancements in CCTA include photon-counting CT (PCCT), which enhances spatial resolution and plaque characterization, AI-enabled CT-based Quantitative Coronary Topography (AI-QCT), and AI-driven risk prediction models. Emerging biomarkers, such as the perivascular fat attenuation index (pFAI), provide novel insights into vascular inflammation, previously assessed only via serum biomarkers. Studies demonstrate CCTA’s prognostic utility in refining risk stratification, guiding therapeutic decisions, and minimizing unnecessary invasive procedures.

Summary

CCTA has become a key tool for anatomical and functional assessment as well as risk prediction in CAD. Future research should focus on AI validation, cost-effectiveness, and imaging integration to advance precision cardiovascular care.