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Open research questions in Cardiac Imaging and Diagnostics

541 gap statements mined from Cardiac Imaging and Diagnostics papers in our 7.9M-paper local library, which holds 3,973 papers on the topic — drawn mostly from each paper's own stated research gap, future-work, challenge and limitation notes, and its abstract. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one.

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What the literature leaves open

  • The study had a small sample size of patients receiving medical therapy alone. The study had limited data on coronary angiography. The study had limited data on the clinical reasons why patients were managed medically.

    Association of Ischemia Localization with Recorded PCI Procedural Category in Patients Undergoing Myocardial Perfusion Imaging · 2026 · DOI

  • The relationship between ischemia localization and PCI procedural category remains less well defined. The anatomical localization of ischemia may be relevant to clinical interpretation and procedural planning, but its impact is not well understood.

    Association of Ischemia Localization with Recorded PCI Procedural Category in Patients Undergoing Myocardial Perfusion Imaging · 2026 · DOI

  • The review discusses the complexity of the diagnostic process and the need for a dynamic approach. The paper mentions the challenge of developing effective treatment strategies for these conditions.

    ANOCA, INOCA, MINOCA: The New Frontier of Coronary Syndromes · 2025 · DOI

  • The paper highlights the need for non-invasive and accurate diagnostic tools for CAD. The paper discusses the current limitations of FFR-CT technology, including image quality requirements and cost.

    Fractional Flow Reserve from Coronary CT: Evidence, Applications, and Future Directions · 2025 · DOI

  • The paper identifies cost and limited accessibility as major challenges to the clinical integration of hybrid PET/CT and PET/MR imaging. The review discusses the limitations of PET/MR, including inferior spatial resolution for coronary imaging and susceptibility to motion-related artifacts. The paper mentions the need for specialized staff and dedicated workflows for hybrid imaging techniques.

    Hybrid PET/CT and PET/MR in Coronary Artery Disease: An Update for Clinicians, with Insights into AI-Guided Integration · 2025 · DOI

  • The interpretation of CAC progression is influenced by preventive therapies. There is a need for a more comprehensive view of subclinical atherosclerosis. The paper identifies the need for further research on the longitudinal use of CACS.

    Role of Coronary Artery Calcium Score CT in Risk Stratification of Asymptomatic Individuals · 2025 · DOI

  • The paper identifies the need for a new frontline test for managing acute chest pain in the ED. The paper highlights the limitations of current methods for evaluating acute chest pain. The paper notes the importance of considering atherosclerotic burden and high-risk plaque features in the evaluation of acute chest pain.

    Coronary CT Angiography in the Emergency Department: State of the Art and Future Perspectives · 2025 · DOI

  • Additional tests, such as stress-rest single-photon emission computed tomography, have limitations, including long acquisition times and significant radiation doses.

    Feasibility, Added Value, and Radiation Dose of Combined Coronary CT Angiography and Stress Dynamic CT Myocardial Perfusion Imaging in Moderate Coronary Artery Disease: A Real-World Study · 2025 · DOI

  • The need for a non-invasive and accurate method for detecting coronary artery disease. The gap in current research is the lack of studies evaluating the correlation between coronary calcium score and coronary artery disease using low-dose dual-source CT.

    Coronary Calcium Scoring as Prediction of Coronary Artery Diseases with Low-Dose Dual-Source CT · 2025 · DOI

  • The high cost and limited availability of CMRI are challenges. Operator-dependent and limited spatial resolution are challenges of dobutamine stress echocardiography. The lack of uniformity in techniques and definitions for myocardial viability is a challenge.

    Myocardial Viability: Evolving Insights and Challenges in Revascularization and Functional Recovery · 2025 · DOI

  • CCTA does not offer information on the functional significance of detected coronary artery stenoses. Additional diagnostic tests are necessary to assess the functional impact of the detected coronary artery stenoses.

    Diagnostic Performance of Dynamic Myocardial Perfusion Imaging Using Third-Generation Dual-Source Computed Tomography in Patients with Intermediate Pretest Probability of Coronary Artery Disease · 2025 · DOI

  • However, it remains unknown if there are structural differences between NOCAD with ischemia (INOCA) and those without ischemia (ANOCA).

    OR2-31 | Cardiac Structural Differences in Angina vs. Ischemia with No Obstructive Coronary Artery Disease · 2026 · DOI

  • A novel artificial intelligence (AI) and machine learning algorithm using spatiotemporal enhancement processing (STEP) has been developed to enhance angiographic images and improve coronary visualization,1,2 but whether STEP improves suboptimal image quality in morbidly obese patients has not been studied.

    Evaluation of an Artificial Intelligence and Machine Learning Algorithm to Enhance Angiographic Coronary Visibility in Morbid Obesity: A Retrospective Observational Study · 2026 · DOI

  • In HeFH, evidence is currently insufficient to support routine CCTA screening at specific ages or intervals.

    Coronary artery calcium scoring and coronary computed tomography angiography in familial hypercholesterolemia: current evidence and future directions · 2026 · DOI

  • General and familial hypercholesterolemia-specific risk scores (SAFEHEART-RE, Montreal-FH, and FH risk score) are insufficient to capture the interindividual variability in cardiovascular risk.

    Coronary artery calcium scoring and coronary computed tomography angiography in familial hypercholesterolemia: current evidence and future directions · 2026 · DOI

  • The combined prognostic implications of NAFLD and CT-FFR in patients with suspected coronary artery disease (CAD) remain uncertain.

    Prognostic association of non-alcoholic fatty liver disease and CT-derived fractional flow reserve in suspected coronary artery disease · 2026 · DOI

  • Left ventricular ejection fraction reserve (LVEF-R), defined as stress EF minus rest EF, is a marker for high-risk coronary artery disease in patients undergoing positron emission tomography myocardial perfusion imaging, but its prognostic and diagnostic significance in large real-world populations remains incompletely defined.

    Prediction of All-Cause Mortality, Cardiovascular Mortality, and Angiographic Coronary Disease From LVEF Reserve: Findings From the Multicenter REFINE PET Registry · 2026 · DOI

  • It remains unclear whether cardiovascular risk increases proportionally with plaque extent in both sexes.

    Risk in Women Emerges at Lower Coronary Plaque Burden Than in Men: PROMISE Trial · 2026 · DOI

  • The relationship between impaired glucose tolerance and high-risk plaque characteristics is not well understood. There is a need to identify patients at elevated risk of coronary artery disease using oral glucose tolerance tests.

    High-Risk Plaque Characteristics in Patients with Suspected Stable Coronary Artery Disease and Impaired Glucose Tolerance: A Coronary Computed Tomography Angiography Study · 2025 · DOI

  • Although the techniques for coronary function testing (CFT) were largely developed more than 30 years ago, consensus on the specific diagnostic criteria and endotypes is still lacking.

    Current Evidence-Based Treatment of Angina With Nonobstructive Coronary Arteries (ANOCA) · 2025 · DOI

  • Combining anatomical data from CCS with functional, genetic, and biochemical markers could pave the way for a more comprehensive and individualized approach to cardiovascular prevention.

    Coronary Calcium Scoring as Prediction of Coronary Artery Diseases with Low-Dose Dual-Source CT · 2025 · DOI

  • Further studies are needed to evaluate the performance of the DL-Algorithm in different populations and imaging conditions - The development of more advanced deep learning algorithms for detecting significant ISR - Investigation of the potential applications of the DL-Algorithm in clinical…

    A deep learning-based algorithm for detecting significant in-stent restenosis in coronary CT angiography · 2026 · DOI

  • Further evaluation of FFR-CT in different patient populations, - Development of new technologies to improve image quality and reduce limitations, - Investigation of the cost-effectiveness of FFR-CT compared to traditional…

    Fractional Flow Reserve from Coronary CT: Evidence, Applications, and Future Directions · 2025 · DOI

  • Spatial resolution (0.3–0.5 mm) is often insufficient to reliably detect some crucial features of vulnerable plaques, - Accurately identifying vulnerable plaque features requires substantial expertise and time, - Challenges remain in visualizing these features within the small coronary arteries due to factors such as attenuation, physiological motion, residual tracer in the bloodstream, and potential myocardial…

    Beyond the Lumen: Molecular Imaging to Unmask Vulnerable Coronary Plaques · 2025 · DOI

  • Further studies are needed to validate the results in a larger population, - Comparison to other non-invasive imaging modalities is necessary, - Assessment of the cost-effectiveness of the combined CCTA and CT-MPI approach is required, - Investigation of the use of dynamic CT-MPI in patients with different pretest probabilities…

    Diagnostic Performance of Dynamic Myocardial Perfusion Imaging Using Third-Generation Dual-Source Computed Tomography in Patients with Intermediate Pretest Probability of Coronary Artery Disease · 2025 · DOI

Most-cited papers in Cardiac Imaging and Diagnostics

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Open questions raised by papers listed on this page include: (1) The anatomical localization of ischemia may be relevant to clinical interpretation and procedural planning, but its impact is not well understood (“Association of Ischemia Localization with Recorded PCI Procedural Category in…”, 2026); (2) It remains unknown if there are structural differences between NOCAD with ischemia (INOCA) and those without ischemia (ANOCA) (“OR2-31 | Cardiac Structural Differences in Angina vs. Ischemia with No…”, 2026); (3) It remains unclear whether cardiovascular risk increases proportionally with plaque extent in both sexes (“Risk in Women Emerges at Lower Coronary Plaque Burden Than in Men: PROMISE Trial”, 2026); (4) There is a need for a more comprehensive view of subclinical atherosclerosis (“Role of Coronary Artery Calcium Score CT in Risk Stratification of Asymptomatic…”, 2025); (5) The gap in current research is the lack of studies evaluating the correlation between coronary calcium score and coronary artery disease using low-dose dual-source CT (“Coronary Calcium Scoring as Prediction of Coronary Artery Diseases with…”, 2025). 541 gap statements have been mined from Cardiac Imaging and Diagnostics papers in our 7.9M-paper local library, which holds 3,973 papers on the topic; the gaps come from whichever of those papers state one. They are mostly the research gaps the authors state and the papers' abstracts, plus future-work, limitations and challenges passages. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one, so you can read the original claim in context.

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