Opportunistic Screening of Carotid Atherosclerosis and Cardiovascular Mortality Risk Using Chest Radiographs: A Comparative Study of Foundation Models.

Rad-DINO achieved the highest performance with selective fine-tuning (area under the receiver operating characteristic curve, 0.74 [95% CI, 0.71-0.77]) and low-rank adaptation (area under the receiver operating characteristic curve, 0.74 [95% CI, 0.70-0.76]), with the highest anatomic relevance under low-rank adaptation (clinical relevance index, 0.31).

The model concordance index was 0.73 (95% CI, 0.67-0.75).