REFERENCES
1. Gulati M, Levy PD, Mukherjee D, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain: a report of the american college of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. Circulation. 2021;144:E368-454.
2. Vrints C, Andreotti F, Koskinas KC, et al. 2024 ESC Guidelines for the management of chronic coronary syndromes: Developed by the task force for the management of chronic coronary syndromes of the European Society of Cardiology (ESC) Endorsed by the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2024;45:3415-537.
3. Edvardsen T, Asch FM, Davidson B, et al. Non-invasive imaging in coronary syndromes: recommendations of The European Association of Cardiovascular Imaging and the American Society of Echocardiography, in collaboration with The American Society of nuclear cardiology, society of cardiovascular computed tomography, and society for cardiovascular magnetic resonance. J Am Soc Echocardiogr. 2022;35:329-54.
4. Serruys PW, Hara H, Garg S, et al. Coronary computed tomographic angiography for complete assessment of coronary artery disease: JACC state-of-the-art review. J Am Coll Cardiol. 2021;78:713-36.
5. Cury RC, Leipsic J, Abbara S, et al. CAD-RADS™ 2.0 - 2022 coronary artery disease-reporting and data system: an expert consensus document of the Society of Cardiovascular Computed Tomography (SCCT), the American College of Cardiology (ACC), the American College of Radiology (ACR), and the North America Society of Cardiovascular Imaging (NASCI). JACC Cardiovasc Imaging. 2022;15:1974-2001.
6. Williams MC, Kwiecinski J, Doris M, et al. Low-attenuation noncalcified plaque on coronary computed tomography angiography predicts myocardial infarction: results from the multicenter SCOT-HEART trial (scottish computed tomography of the HEART). Circulation. 2020;141:1452-62.
7. Tang CX, Leipsic JA, Nørgaard BL, et al. Clinical use of coronary computed tomography angiography-derived fractional flow reserve: expert consensus by an International Working Group. Eur Radiol. 2026;36:5303-16.
8. Picano E, Pierard L, Peteiro J, et al. The clinical use of stress echocardiography in chronic coronary syndromes and beyond coronary artery disease: a clinical consensus statement from the European Association of Cardiovascular Imaging of the ESC. Eur Heart J Cardiovasc Imaging. 2024;25:e65-90.
9. Vohra S, Sakul S, Agarwal V, Patel KK. Quantification of myocardial blood flow using PET: Current status, clinical applications, and future directions. Prog Cardiovasc Dis. 2025;93:10-20.
10. Patel AR, Salerno M, Kwong RY, Singh A, Heydari B, Kramer CM. Stress cardiac magnetic resonance myocardial perfusion imaging : JACC review topic of the week. J Am Coll Cardiol. 2021;78:1655-68.
11. Nagel E, Greenwood JP, Mccann GP, et al. Magnetic resonance perfusion or fractional flow reserve in coronary disease. N Engl J Med. 2019;380:2418-28.
12. Douglas PS, Hoffmann U, Patel MR, et al. Outcomes of anatomical versus functional testing for coronary artery disease. N Engl J Med. 2015;372:1291-300.
13. The DISCHARGE Trial Group. CT or invasive coronary angiography in stable chest pain. N Engl J Med. 2022;386:1591-602.
14. Douglas PS, Nanna MG, Kelsey MD, et al. Comparison of an initial risk-based testing strategy vs usual testing in stable symptomatic patients with suspected coronary artery disease: the PRECISE randomized clinical trial. JAMA Cardiol. 2023;8:904.
15. Williams MC, Wereski R, Tuck C, et al. Coronary CT angiography-guided management of patients with stable chest pain: 10-year outcomes from the SCOT-HEART randomised controlled trial in Scotland. Lancet. 2025;405:329-37.
16. Winchester DE, Maron DJ, Blankstein R, et al. ACC/AHA/ASE/ASNC/ASPC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2023 multimodality appropriate use criteria for the detection and risk assessment of chronic coronary disease. J Am Coll Cardiol. 2023;81:2445-67.
17. Ferencik M, Mayrhofer T, Bittner DO, et al. Use of high-risk coronary atherosclerotic plaque detection for risk stratification of patients with stable chest pain: a secondary analysis of the PROMISE randomized clinical trial. JAMA Cardiol. 2018;3:144.
18. Osawa K, Nakanishi R, Budoff M. Coronary artery calcification; Report from the multi-ethnic study of atherosclerosis. Glob Heart. 2016;11:287.
19. Otaki Y, Arsanjani R, Gransar H, et al. What have we learned from CONFIRM? Prognostic implications from a prospective multicenter international observational cohort study of consecutive patients undergoing coronary computed tomographic angiography. J Nucl Cardiol. 2012;19:787-95.
20. Faulder TI, Prematunga K, Moloi SB, Faulder LE, Jones R, Moxon JV. Agreement of fractional flow reserve estimated by computed tomography with invasively measured fractional flow reserve: a systematic review and meta-analysis. J Am Heart Assoc. 2024;13:e034552.
21. Yang J, Shan D, Wang X, et al. On-site computed tomography-derived fractional flow reserve to guide management of patients with stable coronary artery disease: the TARGET randomized trial. Circulation. 2023;147:1369-81.
22. Guo B, Xing W, Hu C, et al. Clinical effectiveness of automated coronary CT-derived fractional flow reserve: a Chinese randomized controlled trial. Radiology. 2024;313:e233354.
23. Williams MC, Weir-Mccall JR, Baldassarre LA, et al. Artificial intelligence and machine learning for cardiovascular computed tomography (CCT): a white paper of the society of cardiovascular computed tomography (SCCT). J Cardiovasc Comput Tomogr. 2024;18:519-32.
24. Sagoo NS, Sagoo R, Legate J, Sathyamoorthy M. Pericoronary adipose tissue attenuation on CCTA as a marker of cardiovascular risk: a systematic review and meta-analysis. Eur J Radiol. 2026;195:112607.
25. Kato Y, Chehab O, Ambale-Venkatesh B, Lima JAC. Quantitative myocardial perfusion imaging across PET, SPECT, CMR, and CT. Front Radiol. 2026;6:1760241.
26. Sliwicka O, Sechopoulos I, Baggiano A, Pontone G, Nijveldt R, Habets J. Dynamic myocardial CT perfusion imaging—state of the art. Eur Radiol. 2023;33:5509-25.
27. Woodward W, Johnson CL, Krasner S, et al. Long-term outcomes after stress echocardiography in real-world practice: a 5-year follow-up of the UK EVAREST study. Eur Heart J Cardiovasc Imaging. 2025;26:187-96.
28. Zhang P, Tian J, Zhu T, et al. Stress echocardiography for chronic coronary syndrome: clinical practice guidelines (2023). J Geriatr Cardiol. 2024;21:475-505.
29. Haddad K, Ionescu AL, Pilehvar R, et al. Improving stress echocardiography for enhanced detection of left main and multivessel coronary artery disease. CJC Open. 2026;8:93-102.
30. Zivanic A, Stankovic I, Vranic Jovanovic I, et al. The role of post-systolic strain and electrocardiographic changes during dobutamine stress echocardiography in enhancing detection of symptomatic coronary artery disease. Front Cardiovasc Med. 2025;12:1641044.
31. Tjellaug Bråten A, Holte E, Wiseth R, Aakhus S. Dobutamine stress echocardiography after positive CCTA: diagnostic performance using fractional flow reserve and instantaneous wave-free ratio as reference standards. Open Heart. 2024;11:e002899.
32. Kunadian V, Chieffo A, Camici PG, et al. An EAPCI expert consensus document on ischaemia with non-obstructive coronary arteries in collaboration with european society of cardiology working group on coronary pathophysiology & microcirculation endorsed by coronary vasomotor disorders international study group. Eur Heart J. 2020;41:3504-20.
33. Murthy VL, Bateman TM, Beanlands RS, et al. Clinical quantification of myocardial blood flow using PET: joint position paper of the SNMMI cardiovascular council and the ASNC. J Nucl Med. 2018;59:273-93.
34. Taqueti VR, Hachamovitch R, Murthy VL, et al. Global coronary flow reserve is associated with adverse cardiovascular events independently of luminal angiographic severity and modifies the effect of early revascularization. Circulation. 2015;131:19-27.
35. Zhou W, Lee JCY, Leung ST, et al. Long-term prognosis of patients with coronary microvascular disease using stress perfusion cardiac magnetic resonance. JACC Cardiovasc Imaging. 2021;14:602-11.
36. Ford TJ, Stanley B, Good R, et al. Stratified medical therapy using invasive coronary function testing in angina. J Am Coll Cardiol. 2018;72:2841-55.
37. Alwan M, El Ghazawi A, El Yaman A, Al Rifai M, Al-Mallah MH. SPECT myocardial perfusion imaging in the era of PET and multimodality imaging: challenges and opportunities. Prog Cardiovasc Dis. 2025;93:3-9.
38. Dahdal J, Jukema RA, Harms HJ, et al. PET myocardial perfusion imaging: trends, challenges, and opportunities. J Nucl Cardiol. 2024;40:102011.
39. Veneziano FA, Gioia FA, Gentile F. Hybrid PET/CT and PET/MR in coronary artery disease: an update for clinicians, with insights into AI-guided integration. J Cardiovasc Dev Dis. 2025;12:338.
40. El Yaman A, Alwan M, El Ghazawi A, Al-Mallah MH, Al Rifai M. Advances in nuclear hybrid imaging: the role of SPECT/CT, PET/CT, and PET/MRI in cardiovascular diseases. Prog Cardiovasc Dis. 2025;93:43-50.
41. Virani SS, Newby LK, Arnold SV, et al. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA guideline for the management of patients with chronic coronary disease : a report of the American Heart Association/American College of Cardiology Joint Committee on clinical practice guidelines. J Am Coll Cardiol. 2023;82:833-955.
42. Litmanovich D, Hurwitz Kowee LM, Ghoshhajra BB, et al. ACR appropriateness criteria® chronic chest pain-high probability of coronary artery disease: 2021 update. J Am Coll Radiol. 2022;19:S1-18.
43. Ricci F, Khanji MY, Bisaccia G, et al. Diagnostic and prognostic value of stress cardiovascular magnetic resonance imaging in patients with known or suspected coronary artery disease: a systematic review and meta-analysis. JAMA Cardiol. 2023;8:662.
44. Greenwood JP, Maredia N, Younger JF, et al. Cardiovascular magnetic resonance and single-photon emission computed tomography for diagnosis of coronary heart disease (CE-MARC): a prospective trial. Lancet. 2012;379:453-60.
45. Greenwood JP, Ripley DP, Berry C, et al. Effect of care guided by cardiovascular magnetic resonance, myocardial perfusion scintigraphy, or NICE guidelines on subsequent unnecessary angiography rates: the CE-MARC 2 randomized clinical trial. JAMA. 2016;316:1051.
46. Garcia MJ, Kwong RY, Scherrer-Crosbie M, et al. State of the art: imaging for myocardial viability: a scientific statement from the American Heart Association. Circ Cardiovasc Imaging. 2020;13:e000053.
47. Wang S, Kim P, Wang H, et al. Myocardial blood flow quantification using stress cardiac magnetic resonance improves detection of coronary artery disease. JACC Cardiovasc Imaging. 2024;17:1428-41.
48. Narula J, Chandrashekhar Y, Ahmadi A, et al. SCCT 2021 expert consensus document on coronary computed tomographic angiography: a report of the society of cardiovascular computed tomography. J Cardiovasc Comput Tomogr. 2021;15:192-217.
49. Curzen N, Nicholas Z, Stuart B, et al. Fractional flow reserve derived from computed tomography coronary angiography in the assessment and management of stable chest pain: the FORECAST randomized trial. Eur Heart J. 2021;42:3844-52.
50. Knuuti J, Wijns W, Saraste A, et al. 2019 ESC guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2020;41:407-77.
51. National Institute for Health and Care Excellence (NICE). Recent-onset chest pain of suspected cardiac origin: assessment and diagnosis. Available from: https://www.nice.org.uk/guidance/cg95 [Last accessed on 6 Nov 2026].
52. Bax JJ, Di Carli M, Narula J, Delgado V. Multimodality imaging in ischaemic heart failure. Lancet. 2019;393:1056-70.
53. Baessato F, Guglielmo M, Muscogiuri G, et al. Stress CMR in known or suspected CAD: diagnostic and prognostic role. BioMed Res Int. 2021;2021:6678029.
54. Neglia D, Liga R, Gimelli A, et al. Use of cardiac imaging in chronic coronary syndromes: the EURECA Imaging registry. Eur Heart J. 2023;44:142-58.
55. Hirshfeld JW, Ferrari VA, Bengel FM, et al. 2018 ACC/HRS/NASCI/SCAI/SCCT expert consensus document on optimal use of ionizing radiation in cardiovascular imaging—best practices for safety and effectiveness, Part 1: radiation physics and radiation biology: A report of the American College of Cardiology Task Force on expert consensus decision pathways. J Am Coll Cardiol. 2018;71:2811-28.
56. Einstein AJ, Williams MC, Weir-Mccall JR, et al. Worldwide radiation dose in coronary artery disease diagnostic imaging. JAMA. 2026;335:1148.
57. Picano E. Economic, ethical, and environmental sustainability of cardiac imaging. Eur Heart J. 2023;44:4748-51.
58. Van Der Bijl P, Gulati M, Saraste A, et al. Contemporary, non-invasive imaging diagnosis of chronic coronary artery disease. Lancet. 2025;406:2577-87.
59. Hanneman K, Playford D, Dey D, et al. Value creation through artificial intelligence and cardiovascular imaging: a scientific statement from the American Heart Association. Circulation. 2024;149:E296-311.
60. Ihdayhid AR, Sehly A, He A, et al. Coronary artery stenosis and high-risk plaque assessed with an unsupervised fully automated deep learning technique. JACC Adv. 2024;3:100861.
61. Shiyovich A, Singh A, Blair CV, et al. Photon-counting computed tomography in cardiac imaging. JACC Cardiovasc Imaging. 2026;19:94-117.
62. Sakai K, Shin D, Singh M, et al. Diagnostic performance and clinical impact of photon-counting detector computed tomography in coronary artery disease. JACC. 2025;85:339-48.
63. Kotronias RA, De Maria GL, Xie C, et al. Benchmarking photon-counting computed tomography angiography against invasive assessment of coronary stenosis: implications for severely calcified coronaries. JACC Cardiovasc Imaging. 2025;18:572-85.
64. Han D, Lin A, Kuronuma K, et al. Cardiac Computed tomography for quantification of myocardial extracellular volume fraction: a systematic review and meta-analysis. JACC Cardiovasc Imaging. 2023;16:1306-17.
65. Joshi NV, Vesey AT, Williams MC, et al. 18F-fluoride positron emission tomography for identification of ruptured and high-risk coronary atherosclerotic plaques: a prospective clinical trial. Lancet. 2014;383:705-13.
66. Kwiecinski J, Tzolos E, Adamson PD, et al. Coronary 18F-sodium fluoride uptake predicts outcomes in patients with coronary artery disease. J Am Coll Cardiol. 2020;75:3061-74.
67. Lin A, Kolossváry M, Cadet S, et al. Radiomics-based precision phenotyping identifies unstable coronary plaques from computed tomography angiography. JACC Cardiovasc Imaging. 2022;15:859-71.
68. Kolossváry M, Lin A, Kwiecinski J, et al. Coronary plaque radiomic phenotypes predict fatal or nonfatal myocardial infarction. JACC Cardiovasc Imaging. 2025;18:308-19.
69. Thangaraj PM, Benson SH, Oikonomou EK, Asselbergs FW, Khera R. Cardiovascular care with digital twin technology in the era of generative artificial intelligence. Eur Heart J. 2024;45:4808-21.
