Combining Advances in Computed Tomography Angiography with AI to Enhance Preventive Care

Emphasizing the preventative benefit of computed tomography angiography (CTA), C. Alberto Morales, M.D., discussed a friend whose father had a heart attack in his mid-30s. Given the family history, the friend had annual stress testing with cardiologists and was told he was in good shape and even had a zero coronary artery calcium (CAC) score.

However, a CTA scan in Dr. Morales’s office revealed that his friend had diffuse coronary artery disease and a 70 to 80 percent blockage in the mid-right coronary artery (RCA). After aggressive management, follow-up CTA imaging at one year showed a 36 percent decrease in the RCA blockage and stabilization in other arteries, according to Dr. Morales, the owner of South Tampa Cardiology and Advanced Imaging Center in Tampa, Fla.

In a recent interview, Dr. Morales said advances in CTA scanning has led to a significant shift in preventive capabilities with CTA. In addition to significantly lower and more consistent radiation dosing (approximately three millisieverts (mSvs) per CTA scan), Dr. Morales cites the enhanced resolution going from a traditional 64-slice CT scanner to the 560-slice SpotLight CT scanner (Arineta).

“ … The resolution is so much crisper (and) the coronaries are almost still. Now you're able to identify things … such as these soft, 15-mm, 15 percent stenotic plaques that are within the wall that you are missing with the 64-slice CT. The resolution is just so much sharper and, as a result, now you're able to add other pieces of the puzzle, such as artificial intelligence (AI),” noted Dr. Morales.

Dr. Morales said the emergence of adjunctive AI tools with CTA has provided sharper analysis of plaque volume and characteristics.

“AI is leading the way with these advanced CT scanners in a completely new approach to patient care where we can actually identify disease, such as in a screening manner, treat patients, and then we can perform serial surveillance imaging to ensure that treatment is following the path of stabilization or, even in some cases, regression,” posited Dr. Morales.

(Editor’s note: For related content, see “Can Cardiac CTA be a Viable Alternative for Post-Op Assessment of Left Atrial Appendage (LAA) Closure?,” “Can Emerging AI Software Offer Detection of CAD on CCTA on Par with Radiologists?” and “Meta-Analysis Shows Merits of AI with CTA Detection of Coronary Artery Stenosis and Calcified Plaque.”)

For more insights from Dr. Morales, watch the video below.