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Diagnostics
Special Issues
Latest Advances and Prospects in Cardiovascular Imaging
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Latest Advances and Prospects in Cardiovascular Imaging

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 31 December 2025 | Viewed by 6010

Special Issue Editor

Dr. Carlo Liguori

E-Mail Website
Guest Editor
Department of Radiology, Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, 80147 Naples, Italy
Interests: radiology; cardiovascular imaging; abdominal radiology

Special Issue Information

Dear Colleagues,

Cardiovascular imaging plays a pivotal role in the diagnosis and treatment of cardiovascular diseases. It facilitates the early detection of structural abnormalities, functional impairments, and pathological changes in the heart and blood vessels, which is crucial for the timely implementation of therapeutic measures and the prevention of disease progression. During the treatment process, cardiovascular imaging techniques can also be employed to monitor therapeutic efficacy, assess the effectiveness of treatment, and determine the need for treatment regimen adjustments.

This Special Issue will share applications of cardiovascular imaging in clinical diagnosis, advancements in new technologies, challenges, and future directions, including, but not limited to, the following topics:

  • Cardiovascular magnetic resonance (CMR);
  • Cardiac computed tomography (CT);
  • Coronary angiography;
  • Echocardiography;
  • Nuclear medicine imaging;
  • Applications of artificial intelligence (AI).

Original research articles, reviews, and interesting images are welcome.

We look forward to receiving your contributions.

Dr. Carlo Liguori
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiovascular imaging
  • cardiovascular magnetic resonance
  • coronary angiography
  • echocardiography
  • artificial intelligence

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

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Research

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19 pages, 3321 KiB  
Article
Epicardial Adipose Tissue Volume Assessment in the General Population and CAD-RADS 2.0 Score Correlation Using Dual Source Cardiac CT
by Federica Dell’Aversana, Renato Tuccillo, Alessandro Monfregola, Leda De Angelis, Giovanni Ferrandino, Carlo Tedeschi, Fulvio Cacciapuoti, Fabio Tamburro and Carlo Liguori
Diagnostics 2025, 15(6), 681; https://doi.org/10.3390/diagnostics15060681 - 10 Mar 2025
Viewed by 873
Abstract
Objectives: Our study aims to investigate the correlation between epicardial adipose tissue (EAT) volume assessed with non-contrast cardiac CT (NCCCT) and sex, age, coronary artery disease reporting and data system (CAD-RADS 2.0) categories, and coronary artery calcification (CAC) extent. The secondary aim is [...] Read more.
Objectives: Our study aims to investigate the correlation between epicardial adipose tissue (EAT) volume assessed with non-contrast cardiac CT (NCCCT) and sex, age, coronary artery disease reporting and data system (CAD-RADS 2.0) categories, and coronary artery calcification (CAC) extent. The secondary aim is to establish the average values of EAT in a population considered healthy for coronary artery disease (CAD). Materials and Methods: We retrospectively analyzed patients who underwent coronary computed tomography angiography (CCTA) at our institution from January 2023 to August 2024. The CAD-RADS 2.0 scoring system was applied to assess the extent of CAD; CAC extent was quantified according to the Agatston score. EAT was segmented semi-automatically in NCCCT images, and its volume was subsequently measured. Correlation analyses between EAT volume, sex, patient age, CAC, and CAD-RADS categories were conducted. Results: A total of 489 consecutive patients met the inclusion criteria (63.96 ± 12.18 years; 214 females). The mean EAT volume ± SD in those categorized as CAD-RADS 0 (57.25 ± 15.45 years, 120 patients) was 117.43 ± 50.30 cm3: values were higher in men (121.07 ± 53.31 cm3) than in women (114.54 ± 47.98 cm3). EAT volumes positively correlated with age, male sex, CAD severity, and CAC scores. Conclusions: According to our results, males in all CAD-RADS categories have a greater amount of EAT than females. A positive correlation between the volume of EAT and factors such as age (p = 0.003), CAD-RADS categories (p: 0.004), and coronary calcium score (p = 0.0001) with a strong influence exerted by sex was demonstrated. Our results reinforce the observation that higher EAT volumes are associated with a more severe coronary artery disease. Full article
(This article belongs to the Special Issue Latest Advances and Prospects in Cardiovascular Imaging)
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Review

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15 pages, 4261 KiB  
Review
Trends in Clinical Cardiac Photon-Counting Detector CT Research: A Comprehensive Bibliometric Analysis
by Arosh S. Perera Molligoda Arachchige, Federica Catapano, Costanza Lisi, Jad El Choueiri, Francesca Pellicanò, Stefano Figliozzi, Letterio S. Politi and Marco Francone
Diagnostics 2025, 15(4), 504; https://doi.org/10.3390/diagnostics15040504 - 19 Feb 2025
Viewed by 1087
Abstract
Photon-counting detector computed tomography (PCD-CT) represents a significant advancement in radiological imaging, offering substantial potential for cardiac applications that remain partially underexplored. This bibliometric analysis investigates the evolution and current clinical application of cardiac PCD-CT by examining research trends from 2019 to 2024. [...] Read more.
Photon-counting detector computed tomography (PCD-CT) represents a significant advancement in radiological imaging, offering substantial potential for cardiac applications that remain partially underexplored. This bibliometric analysis investigates the evolution and current clinical application of cardiac PCD-CT by examining research trends from 2019 to 2024. The analysis aims to understand the development of this technology, its clinical implications, and future directions. A comprehensive literature search was conducted using databases such as PubMed, EMBASE, Scopus, and Google Scholar, yielding 984 records. After removing duplicates and applying inclusion criteria, 81 studies were included in the final analysis. These studies primarily focused on coronary artery calcium scoring, coronary atherosclerotic plaque assessment, and coronary artery stenosis quantification. The findings indicate a significant upward trend in the number of publications, peaking in 2023. The bibliometric analysis revealed that the USA, Germany, and Switzerland are the leading contributors to PCD-CT research, with prominent institutions like the Mayo Clinic and the University of Zurich driving advancements in the field. The NAEOTOM Alpha by Siemens Healthineers, being the only commercially available PCD-CT model, highlights its central role in cardiac imaging studies. Funding for PCD-CT research came from various sources, including industry leaders like Siemens and Bayer, as well as governmental and academic institutions. The analysis also identified several challenges that PCD-CT research faces, including the need for larger patient cohorts and broader geographical representation. In conclusion, the rapid growth of cardiac PCD-CT research underscores its transformative potential in clinical practice. Continued investment, collaboration, and extensive research are essential to fully harness the benefits of PCD-CT. Full article
(This article belongs to the Special Issue Latest Advances and Prospects in Cardiovascular Imaging)
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14 pages, 626 KiB  
Review
PET-CT Imaging in Hypertrophic Cardiomyopathy: A Narrative Review on Risk Stratification and Prognosis
by Patrícia Marques-Alves, Lino Gonçalves and Maria João Ferreira
Diagnostics 2025, 15(2), 133; https://doi.org/10.3390/diagnostics15020133 - 8 Jan 2025
Viewed by 922
Abstract
Hypertrophic cardiomyopathy (HCM) is a heterogeneous cardiac disease and one of its major challenges is the limited accuracy in stratifying the risk of sudden cardiac death (SCD). Positron emission tomography (PET), through the evaluation of myocardial blood flow (MBF) and metabolism using fluorodeoxyglucose [...] Read more.
Hypertrophic cardiomyopathy (HCM) is a heterogeneous cardiac disease and one of its major challenges is the limited accuracy in stratifying the risk of sudden cardiac death (SCD). Positron emission tomography (PET), through the evaluation of myocardial blood flow (MBF) and metabolism using fluorodeoxyglucose (FDG) uptake, can reveal microvascular dysfunction, ischemia, and increased metabolic demands in the hypertrophied myocardium. These abnormalities are linked to several factors influencing disease progression, including arrhythmia development, ventricular dilation, and myocardial fibrosis. Fibroblast activation can also be evaluated using PET imaging, providing further insights into early-stage myocardial fibrosis. Conflicting findings underscore the need for further research into PET’s role in risk stratification for HCM. If PET can establish a connection between parameters such as abnormal MBF or increased FDG uptake and SCD risk, it could enhance predictive accuracy. Additionally, PET holds significant potential for monitoring therapeutic outcomes. The aim of this review is to provide a comprehensive overview of the most significant data on disease progression, risk stratification, and prognosis in patients with HCM using cardiac PET-CT imaging. Full article
(This article belongs to the Special Issue Latest Advances and Prospects in Cardiovascular Imaging)
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26 pages, 5902 KiB  
Review
Computed Tomography Evaluation of Coronary Atherosclerosis: The Road Travelled, and What Lies Ahead
by Chadi Ayoub, Isabel G. Scalia, Nandan S. Anavekar, Reza Arsanjani, Clinton E. Jokerst, Benjamin J. W. Chow and Leonard Kritharides
Diagnostics 2024, 14(18), 2096; https://doi.org/10.3390/diagnostics14182096 - 23 Sep 2024
Cited by 2 | Viewed by 2292
Abstract
Coronary CT angiography (CCTA) is now endorsed by all major cardiology guidelines for the investigation of chest pain and assessment for coronary artery disease (CAD) in appropriately selected patients. CAD is a leading cause of morbidity and mortality. There is extensive literature to [...] Read more.
Coronary CT angiography (CCTA) is now endorsed by all major cardiology guidelines for the investigation of chest pain and assessment for coronary artery disease (CAD) in appropriately selected patients. CAD is a leading cause of morbidity and mortality. There is extensive literature to support CCTA diagnostic and prognostic value both for stable and acute symptoms. It enables rapid and cost-effective rule-out of CAD, and permits quantification and characterization of coronary plaque and associated significance. In this comprehensive review, we detail the road traveled as CCTA evolved to include quantitative assessment of plaque stenosis and extent, characterization of plaque characteristics including high-risk features, functional assessment including fractional flow reserve-CT (FFR-CT), and CT perfusion techniques. The state of current guideline recommendations and clinical applications are reviewed, as well as future directions in the rapidly advancing field of CT technology, including photon counting and applications of artificial intelligence (AI). Full article
(This article belongs to the Special Issue Latest Advances and Prospects in Cardiovascular Imaging)
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Other

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16 pages, 1085 KiB  
Systematic Review
Explainable Artificial Intelligence in Radiological Cardiovascular Imaging—A Systematic Review
by Matteo Haupt, Martin H. Maurer and Rohit Philip Thomas
Diagnostics 2025, 15(11), 1399; https://doi.org/10.3390/diagnostics15111399 - 31 May 2025
Viewed by 438
Abstract
Background: Artificial intelligence (AI) and deep learning are increasingly applied in cardiovascular imaging. However, the “black box” nature of these models raises challenges for clinical trust and integration. Explainable Artificial Intelligence (XAI) seeks to address these concerns by providing insights into model decision-making. [...] Read more.
Background: Artificial intelligence (AI) and deep learning are increasingly applied in cardiovascular imaging. However, the “black box” nature of these models raises challenges for clinical trust and integration. Explainable Artificial Intelligence (XAI) seeks to address these concerns by providing insights into model decision-making. This systematic review synthesizes current research on the use of XAI methods in radiological cardiovascular imaging. Methods: A systematic literature search was conducted in PubMed, Scopus, and Web of Science to identify peer-reviewed original research articles published between January 2015 and March 2025. Studies were included if they applied XAI techniques—such as Gradient-Weighted Class Activation Mapping (Grad-CAM), Shapley Additive Explanations (SHAPs), Local Interpretable Model-Agnostic Explanations (LIMEs), or saliency maps—to cardiovascular imaging modalities, including cardiac computed tomography (CT), magnetic resonance imaging (MRI), echocardiography and other ultrasound examinations, and chest X-ray (CXR). Studies focusing on nuclear medicine, structured/tabular data without imaging, or lacking concrete explainability features were excluded. Screening and data extraction followed PRISMA guidelines. Results: A total of 28 studies met the inclusion criteria. Ultrasound examinations (n = 9) and CT (n = 9) were the most common imaging modalities, followed by MRI (n = 6) and chest X-rays (n = 4). Clinical applications included disease classification (e.g., coronary artery disease and valvular heart disease) and the detection of myocardial or congenital abnormalities. Grad-CAM was the most frequently employed XAI method, followed by SHAP. Most studies used saliency-based techniques to generate visual explanations of model predictions. Conclusions: XAI holds considerable promise for improving the transparency and clinical acceptance of deep learning models in cardiovascular imaging. However, the evaluation of XAI methods remains largely qualitative, and standardization is lacking. Future research should focus on the robust, quantitative assessment of explainability, prospective clinical validation, and the development of more advanced XAI techniques beyond saliency-based methods. Strengthening the interpretability of AI models will be crucial to ensuring their safe, ethical, and effective integration into cardiovascular care. Full article
(This article belongs to the Special Issue Latest Advances and Prospects in Cardiovascular Imaging)
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