Evidence map›Paper›PMID 39373817›Full record

ArticleThe international journal of cardiovascular imaging2024

Artificial intelligence-enhanced detection of subclinical coronary artery disease in athletes: diagnostic performance and limitations.

Jens Kübler, Jan M Brendel, Thomas Küstner, Jonathan Walterspiel, Florian Hagen, Jean-François Paul, Konstantin Nikolaou, Sebastian Gassenmaier, Ilias Tsiflikas, Christof Burgstahler and 3 more

Abstract read
In one paragraph

Article in The international journal of cardiovascular imaging, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Jens KüblerDepartment of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, 72076, Tübingen, Germany. jens.kuebler@med.uni-tuebingen.de.
Jan M BrendelDepartment of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, 72076, Tübingen, Germany.
Thomas KüstnerDepartment of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, 72076, Tübingen, Germany.
Jonathan WalterspielDepartment of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, 72076, Tübingen, Germany.
Florian HagenDepartment of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, 72076, Tübingen, Germany.
Jean-François PaulDepartment of Radiology, Institut Mutualiste Montsouris, Cardiac Imaging, 75014, Paris, France.
Konstantin NikolaouDepartment of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, 72076, Tübingen, Germany.
Sebastian GassenmaierDepartment of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, 72076, Tübingen, Germany.
Ilias TsiflikasDepartment of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, 72076, Tübingen, Germany.
Christof BurgstahlerDepartment of Internal Medicine V, Sports Medicine, University of Tübingen, Tübingen, Germany.
Simon GreulichDepartment of Internal Medicine III, Cardiology and Angiology, University of Tübingen, 72076, Tübingen, Germany.
Moritz T WinkelmannDepartment of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, 72076, Tübingen, Germany.
Patrick KrummDepartment of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, 72076, Tübingen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study evaluates the diagnostic performance of artificial intelligence (AI)-based coronary computed tomography angiography (CCTA) for detecting coronary artery disease (CAD) and assessing fractional flow reserve (FFR) in asymptomatic male marathon runners. MATERIAL AND

methodsWe prospectively recruited 100 asymptomatic male marathon runners over the age of 45 for CAD screening. CCTA was analyzed using AI models (CorEx and Spimed-AI) on a local server. The models focused on detecting significant CAD (≥ 50% diameter stenosis, CAD-RADS 3, 4, or 5) and distinguishing hemodynamically significant stenosis (FFR ≤ 0.8) from non-significant stenosis (FFR > 0.8). Statistical analysis included sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy.

resultsThe AI model demonstrated high sensitivity, with 91.2% for any CAD and 100% for significant CAD, and high NPV, with 92.7% for any CAD and 100% for significant CAD. The diagnostic accuracy was 73.4% for any CAD and 90.4% for significant CAD. However, the PPV was lower, particularly for significant CAD (25.0%), indicating a higher incidence of false positives.

conclusionAI-enhanced CCTA is a valuable non-invasive tool for detecting CAD in asymptomatic, low-risk populations. The AI model exhibited high sensitivity and NPV, particularly for identifying significant stenosis, reinforcing its potential role in screening. However, limitations such as a lower PPV and overestimation of disease indicate that further refinement of AI algorithms is needed to improve specificity. Despite these challenges, AI-based CCTA offers significant promise when integrated with clinical expertise, enhancing diagnostic accuracy and guiding patient management in low-risk groups.

Indexed as

Artificial IntelligenceAsymptomatic DiseasesAthletesComputed Tomography AngiographyCoronary AngiographyCoronary Artery DiseaseCoronary StenosisFractional Flow Reserve, MyocardialPredictive Value of TestsAgedCoronary VesselsHumansMaleMiddle AgedProspective StudiesRadiographic Image Interpretation, Computer-AssistedArtificial intelligenceCoronary artery diseaseCoronary computed tomography angiographyDiagnostic accuracyFractional flow reserveMarathon runners

Identifiers

PMID39373817
PMCPMC11618201

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.