Novel Post-Processing Imaging in Cardiology: Current Status and Future Directions

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".

Deadline for manuscript submissions: 25 June 2025 | Viewed by 741

Special Issue Editors


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Guest Editor
1. Integrated Heart Center, Share Zedek Medical Center, Jerusalem 9103102, Israel
2. Faculty of Medicine, Hebrew University, Jerusalem 9112102, Israel
Interests: implantable devices; arrhythmia pathogenesis and ablations; cardiac electrophysiology
Special Issues, Collections and Topics in MDPI journals
Cardiology Department, Shaare Zedek Medical Center, Jerusalem 9103102, Israel
Interests: computed tomography; myocardial infarction; cardiac CT; cardiac imaging; cardiac MRI; cardiovascular imaging
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Several imaging post-processing techniques are increasingly being integrated into daily clinical practice in cardiology. These include trans-thoracic echocardiography global longitudinal strain (GLS) analyses, computerized tomography (CT) radiomic analyses, and cardiac magnetic resonance (CMR) imaging scar tissue analyses using dedicated software such as ADAS (Barcelona, Spain). Strain analysis is based on echocardiographic speckle tracking, enabling the direct evaluation of myocardial contractility. GLS has been proven to be a more accurate and sensitive measure of left-ventricular (LV) systolic function and less prone to afterload conditions compared with LV ejection fraction (EF) assessment. GLS has also seen increasing use in various areas of cardiology, including 1) the diagnosis of LV hypertrophy etiologies; 2) the assessment of ischemia; 3) the evaluation of asymptomatic valvular disease, predicting future symptoms and mortality; 4) cardio-oncology and the early detection of chemotherapy-induced cardiotoxicity; and 5) predicting responses to cardiac resynchronization therapy (CRT). Radiomics is a precise method of extracting numerous (thousands of) quantitative parameters and features from diagnostic digital images, such as CT or CMR, including complex patterns and subtle variations that cannot be identified by the human eye. Although it has been widely investigated in oncology, radiomics has only recently been recognized as an invaluable diagnostic tool in cardiology. Using radiomic feature analysis in the left-atrial adipose tissue, we could predict AF recurrence post-ablation and possibly also detect occult AF. We aim to investigate the use of these techniques to diagnose and predict outcomes in various other fields in cardiology.

Dr. Moshe Rav-Acha
Dr. Arik Wolak
Guest Editors

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Keywords

  • cardiac imaging
  • cardiac magnetic resonance
  • echocardiography
  • computed tomography
  • trans-thoracic echocardiography global longitudinal strain (GLS) analyses
  • radiomics

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Published Papers (1 paper)

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Research

12 pages, 475 KiB  
Article
Evaluation of Prospective ECG-Triggered CT Scan as a Practical Alternative to Standard Retrospective ECG-Gated Scan for Pre-TAVI Patients
by Itshak Amsalem, Itzhak Vitkon-Barkay, Moshe Rav-Acha, Danny Dvir, Matan Elkan, Olga Pichkhadze, Naama Bogot, Fauzi Shaheen, Rafael Hitter, Boris Chutko, Michael Glikson, Jonathon Leipsic and Arik Wolak
J. Clin. Med. 2025, 14(3), 878; https://doi.org/10.3390/jcm14030878 - 28 Jan 2025
Viewed by 562
Abstract
Purpose: CT-TAVI is a critical component of pre-TAVI assessment. The conventional method, retrospective ECG-gated scan, covering a complete cardiac cycle, measures the annulus during optimal systolic phases. Recently, prospective ECG-triggered scans acquiring images at a specific interval of the cardiac cycle were evaluated, [...] Read more.
Purpose: CT-TAVI is a critical component of pre-TAVI assessment. The conventional method, retrospective ECG-gated scan, covering a complete cardiac cycle, measures the annulus during optimal systolic phases. Recently, prospective ECG-triggered scans acquiring images at a specific interval of the cardiac cycle were evaluated, allowing faster acquisition and lower contrast doses. Moreover, these scans might be beneficial for elderly patients, reducing the need for breath-holding and easing cooperation requirements. Still, their impact on annular measurement and procedural success has yet to be fully evaluated. Methods: This retrospective, single-center study included 419 patients who underwent CT-TAVI scans, by either prospective or retrospective scanning methods. Baseline data and calculated surgical risk scores were collected, with propensity score matching performed, followed by univariate analysis, Cox regression, and multivariable regression analysis. Results: A total of 171 patient pairs were generated via propensity score matching, ensuring that both groups had similar distributions of age (81 ± 8 years), sex (55% males), and baseline comorbidities. The patients in the prospective ECG-triggered group were exposed to a smaller amount of contrast material (40.0 ± 12 mL vs. 70.0 ± 48 mL, p < 0.001) and radiation (4.4 ± 3.6 mSv vs. 8.0 ± 10.3 mSv, p < 0.001). The prospective ECG-triggered group had a smaller aortic annulus area and diameter (426.6 ± 121.0 mm2 vs. 469.1 ± 130.8 mm2, p = 0.006 and 23.3 ± 3.2 mm vs. 24.5 ± 3.6 mm, p = 0.004) but no excess paravalvular leak was observed. Multivariable analysis showed no significant differences in mortality and composite endpoints between the two groups after 23 months of follow-up. Conclusion: Prospective ECG-triggered, ultra-fast, low-dose, high-pitch scan protocol, used in selected patients offers comparable safety and clinical procedural outcomes along with time and contrast savings. Full article
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