Coronary CT Angiography, Cardiac MRI and PET/CT Scan: Advancing Cardiac Imaging and Clinical Decision Making in Cardiomyopathies

Dear Colleagues,

Recent advances in noninvasive cardiac imaging have substantially enhanced the evaluation of cardiomyopathies. Coronary computed tomography angiography (CCTA), cardiovascular magnetic resonance (CMR), and positron emission tomography/computed tomography (PET/CT) now provide complementary and synergistic information, enabling a comprehensive assessment of myocardial structure, function, perfusion, metabolism, and tissue characteristics. Together, these modalities play a pivotal role in the diagnosis, phenotyping, and risk stratification of a broad spectrum of cardiomyopathies, including hypertrophic, dilated, arrhythmogenic, inflammatory, and infiltrative diseases.

Technological progress in scanner hardware, acquisition techniques, and image reconstruction have significantly improved diagnostic performance while enhancing safety and efficiency across all three modalities. CCTA offers robust noninvasive evaluation of coronary anatomy, allowing reliable exclusion of ischemic heart disease in patients with suspected cardiomyopathy while also providing detailed assessment of myocardial morphology and plaque characteristics, including quantification of atherosclerotic burden. CMR enables precise evaluation of cardiac structure and function and is uniquely suited for myocardial tissue characterization through techniques such as late gadolinium enhancement and parametric mapping, facilitating the detection of fibrosis, edema, and infiltration. PET/CT, in turn, provides unique insights into myocardial perfusion, metabolism, and inflammatory activity, playing a key role in the evaluation of inflammatory and infiltrative cardiomyopathies, including cardiac sarcoidosis.

Importantly, the integration of these imaging modalities within a multimodality framework allows for a more comprehensive and nuanced characterization of disease processes than any single technique alone. The combination of anatomical, functional, and molecular information enhances diagnostic accuracy, refines risk stratification, and supports more personalized therapeutic decision-making. Furthermore, the incorporation of advanced quantitative approaches, including radiomics and artificial intelligence–based tools, is expanding the ability of imaging to detect subtle phenotypic features, monitor disease progression, and assess response to emerging therapies.

This Special Issue aims to present a comprehensive collection of high-quality original research and review articles focusing on recent advances in multimodality cardiac imaging in cardiomyopathies. We particularly encourage submissions addressing priority areas, such as the development and validation of imaging biomarkers, the application of artificial intelligence and radiomics, and disease-specific multimodality imaging strategies. We welcome contributions exploring novel imaging techniques, emerging biomarkers, and integrative imaging approaches that advance the understanding and clinical management of cardiomyopathies.

Dr. Alexios S. Antonopoulos
Dr. Spyridon Simantiris
Guest Editors

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• coronary CT angiography
• cardiac magnetic resonance imaging
• cardiac positron emission tomography
• cardiac imaging
• cardiomyopathies
• cardiac amyloidosis
• cardiac sarcoidosis
• hypertrophic cardiomyopathy
• dilated cardiomyopathy
• non-dilated left ventricular cardiomyopathy
• arrhythmogenic right ventricular cardiomyopathy
• restrictive cardiomyopathy
• risk stratification
• clinical decision making
• artificial intelligence
• radiomics