Automated AI-Based Aortic Measurements From Attenuation Correction CT as an Adjunctive Cardiovascular Risk…

AI / informaticsCirculation. Cardiovascular imaging· Jul 2026

Automated AI-Based Aortic Measurements From Attenuation Correction CT as an Adjunctive Cardiovascular Risk Biomarker: An International Multicenter Study.

Anna M Marcinkiewicz, Aakash Shanbhag, Panithaya Chareonthaitawee … Piotr J Slomka

Nuclear MedicineAI / informaticsPrognosisQ1IF 3.6

Enlarged descending aorta on routine cardiac computed tomography scans is linked to higher mortality.

Automated AI-Based Aortic Measurements From Attenuation Correction CT as an Adjunctive Cardiovascular Risk Biomarker: An International Multicenter Study.

Anna M Marcinkiewicz … Piotr J Slomka

Circulation · Jul 2026 · Q1 in Radiology

Background

Aortic enlargement is a powerful predictor of dissection and rupture, yet it is rarely evaluated during routine myocardial perfusion imaging, despite the widespread availability of computed tomography (computed tomography) attenuation correction scans.

Purpose

The aim of this study was to determine whether fully automated, opportunistically derived, artificial intelligence-based aortic measurements from myocardial perfusion imaging computed tomography attenuation correction scans are associated with adverse outcomes in a large multicenter cohort.

Methods

Computed tomography attenuation correction scans from patients undergoing positron emission tomography/computed tomography and single-photon emission computed tomography/computed tomography myocardial perfusion imaging across 10 centers were included.

n = 339 patients

Results

larger descending aorta on routine computed tomography means higher risk of death

HR 1.16 (95% CI 1.07 to 1.26)

CI excludes the null - significant

More results

Median ascending and descending aortic size index values were 1.8 cm/m 2 (interquartile range, 1.6-2.0) and 1.5 cm/m 2 (interquartile range, 1.4-1.6), respectively, with an increase with age and higher values in females.

Notably, the prognostic value of an abnormal aortic size index persisted independent of age, sex, and perfusion abnormalities.

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Conclusion · 1 of 2

Artificial intelligence can unlock previously unused information within routine myocardial perfusion imaging computed tomography attenuation correction scans by rapidly and automatically quantifying aortic size at scale.

Conclusion · 2 of 2

Opportunistic aortic measurements derived from computed tomography attenuation correction may serve as an adjunctive risk biomarker and could add prognostic value to standard myocardial perfusion imaging without additional imaging or radiation.

Automated AI-Based Aortic Measurements From Attenuation Correction CT as an Adjunctive Cardiovascular Risk Biomarker: An International Multicenter Study.

Automated AI-Based Aortic Measurements From Attenuation Correction CT as an Adjunctive Cardiovascular Risk Biomarker: An International Multicenter Study.

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