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Rationale and Objectives: Coronary CT angiography (CCTA) is mandatory before transcatheter aortic valve replacement (TAVR). Our objective was to evaluate the efficacy of artificial intelligence (AI)-powered software in automatically analyzing cardiac parameters from pre-procedural CCTA to predict major adverse cardiovascular events (MACE) in TAVR patients., Materials and Methods: Patients undergoing pre-TAVR CCTA were retrospectively included. AI software automatically extracted 34 morphologic and volumetric cardiac parameters characterizing the ventricles, atria, myocardium, and epicardial adipose tissue. Clinical information and outcomes were recorded from institutional database. Cox regression analysis identified predictors of MACE, including non-fatal myocardial infarction, heart failure hospitalization, unstable angina, and cardiac death. Model performance was evaluated with Harrell's C-index, and nested models were compared using the likelihood ratio test. Manual analysis of 170 patients assessed agreement with automated measurements., Results: Among the 648 enrolled patients (77 ± 9.3 years, 58.9% men), 116 (17.9%) experienced MACE within a median follow-up of 24 months (interquartile range 10-40). After adjusting for clinical parameters, only left ventricle long axis shortening (LV-LAS) was an independent predictor of MACE (hazard ratio [HR], 1.05 [95% confidence interval, 1.05-1.11]; p = 0.04), with significantly improved C-index (0.620 vs. 0.633; p < 0.001). When adjusted for the Society of Thoracic Surgeons Predicted Risk of Mortality score, LV-LAS was also predictive of MACE (HR, 1.08 [95%CI, 1.03-1.13]; p = 0.002), while improving model performance (C-index: 0.557 vs. 0.598; p < 0.001). All parameters showed good or excellent agreement with manual measurements., Conclusion: Automated AI-based comprehensive cardiac assessment enables pre-TAVR MACE prediction, with LV-LAS outperforming all other parameters., Competing Interests: Declaration of Competing Interest The authors of this manuscript declare relationships with the following companies: A.V-S.: receives institutional research support and/or personal subscriptions from Siemens and Elucid Bioimaging; U.J.S.: receives institutional research support and/or personal fees by Bayer, Bracco, Elucid BioImaging, Guerbet, HeartFlow, Inc., Keya Medical, and Siemens; A.J.: is an employee of Siemens Medical Solutions USA Inc; P.S.: is an employee of Siemens Medical Solutions USA Inc; S.R.: is an employee of Siemens Medical Solutions USA Inc; J.O.: is an employee of Siemens Medical Solutions USA Inc; T.E.: receives travel support and speaker fee from Siemens Medical Solutions USA Inc, institutional research support by Siemens Healthineers and is a consultant for Circle Cardiovascular Imaging; For the remaining authors, none were declared., (Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Since its inaugural issue in 2019, Radiology: Cardiothoracic Imaging has disseminated the latest scientific advances and technical developments in cardiac, vascular, and thoracic imaging. In this review, we highlight select articles published in this journal between October 2021 and October 2022. The scope of the review encompasses various aspects of coronary artery and congenital heart diseases, vascular diseases, thoracic imaging, and health services research. Key highlights include changes in the revised Coronary Artery Disease Reporting and Data System 2.0, the value of coronary CT angiography in informing prognosis and guiding treatment decisions, cardiac MRI findings after COVID-19 vaccination or infection, high-risk features at CT angiography to identify patients with aortic dissection at risk for late adverse events, and CT-guided fiducial marker placement for preoperative planning for pulmonary nodules. Ongoing research and future directions include photon-counting CT and artificial intelligence applications in cardiovascular imaging. Keywords: Pediatrics, CT Angiography, CT-Perfusion, CT-Spectral Imaging, MR Angiography, PET/CT, Transcatheter Aortic Valve Implantation/Replacement (TAVI/TAVR), Cardiac, Pulmonary, Vascular, Aorta, Coronary Arteries © RSNA, 2023., Competing Interests: Disclosures of conflicts of interest: D.M. Grants or contracts from the National Institute of Biomedical Imaging and Bioengineering (no. 5T32EB009035); consulting fees from Segmed; stock or stock options in Segmed; member of Radiology: Cardiothoracic Imaging trainee editorial board. G.J.A. Member of Radiology: Cardiothoracic Imaging trainee editorial board. K.G.O. Payment or honoraria from Grand Rounds for lectures, presentations, speakers bureaus, manuscript writing, or educational events; president of the Society of Cardiovascular Magnetic Resonance; associate editor for Radiology: Cardiothoracic Imaging. D.V. Treasurer of the North American Society for Cardiovascular Imaging; member of Radiology: Cardiothoracic Imaging editorial board; mentor for Radiology: Cardiothoracic Imaging trainee editorial board. D.F. Deputy editor for Radiology: Cardiothoracic Imaging. S.A. Royalties from Elsevier for textbook authorship; member of the board of directors of the Society of Cardiovascular Computed Tomography; editor of Radiology: Cardiothoracic Imaging. K.H. Payment or honoraria from Sanofi Genzyme for lectures, presentations, speakers bureaus, manuscript writing, or educational events; associate editor and trainee editorial board lead for Radiology: Cardiothoracic Imaging., (© 2023 by the Radiological Society of North America, Inc.)