Artificial Intelligence in Cardiac CT: Automated Calcium Scoring and Plaque Analysis

To review the current applications of artificial intelligence (AI) for coronary artery calcium scoring (CACS) and plaque analysis with their achievements and potential clinical impacts. Recent advances of AI-based technologies especially deep learning (DL) approaches in medical imaging have achieved substantial progress in automated detection and characterization of coronary atherosclerotic plaques, providing promising results for AI application in diagnosis and management of coronary artery disease. To date, many studies investigated the potential role of DL in CACS and showed promising results for clinical application in a variety of CT examinations, demonstrating excellent agreement compared with manual scoring. DL-based approaches have also provided considerable progress in automated analysis of non-calcified plaque. Many investigations have shown that automated localization and classification of non-calcified plaque and luminal stenosis is feasible in cardiac CT angiography, although still challenging.