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Open research questions in Cardiac Imaging and Diagnostics

132 unresolved questions extracted from the limitations and future-work sections of 446 Cardiac Imaging and Diagnostics papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • The paper identifies the challenge of accessing large-scale, heterogeneous training data to develop and validate AI-enabled methods. It also highlights the need to address concerns over generalisability, fairness, and interpretability of AI-enabled methods. The paper discusses the challenge of translating AI-enabled methods into clinical practice, including the need for regulatory approval and clinical deployment.

    Promises and challenges of AI-enabled methods for myocardial characterisation in cardiovascular magnetic resonance · 2026 · DOI

  • Future developments may include AI-driven co-registration of multiple CMR modalities-such as cines, LGE, DTI, and parametric maps-into a unified and more coherent three-dimensional representation. End-to-end deep learning approaches for probabilistic risk prediction from CMR images are also likely to expand, with explainable AI supporting interpretability and clinician trust. Work is needed for deployment across scanners and vendors.

    Promises and challenges of AI-enabled methods for myocardial characterisation in cardiovascular magnetic resonance · 2026 · DOI

  • Several studies are necessary to confirm the hypothesis - Investigating the effects of hyperglycemia on endothelial function - Evaluating the role of metformin in the treatment of hyperglycemic patients with INOCA

    Hyperglycemia, diabetes, and coronary microvascular dysfunction in INOCA · 2025 · DOI

  • further studies are needed to confirm the findings, - investigation of other LGE quantification techniques

    Reproducibility of late gadolinium enhancement quantification techniques in ischemic and non-ischemic heart diseases (ReLate study) · 2025 · DOI

  • Differences in endpoint definitions and study populations compared to large multicenter trials, - Study population limited to 222 inpatients newly diagnosed with CCS

    Combined prognostic value of AI-derived CT-FFR and high-risk plaque characteristics in patients with newly diagnosed chronic coronary syndrome: a prospective cohort study · 2025 · DOI

  • Further studies to evaluate the clinical utility of CT-FFR and HRPC for risk stratification, - Investigation of the combined prognostic value of CT-FFR and HRPC in different patient populations

    Combined prognostic value of AI-derived CT-FFR and high-risk plaque characteristics in patients with newly diagnosed chronic coronary syndrome: a prospective cohort study · 2025 · DOI

  • There is no consensus in the various good clinical practice guidelines (CPG) on the use of this score.

    Calcium score: what do the most reliable guidelines recommend? An analysis using the G-TRUST tool · 2025 · DOI

  • The exact mechanism underlying the pathophysiology of INOCA is still lacking; however, currently there are two main hypotheses that seem to prevail: coronary microvascular dysfunction with microvascular angina and epicardial coronary artery spasm [8].

    Hyperglycemia, diabetes, and coronary microvascular dysfunction in INOCA · 2025 · DOI

  • However, consensus on the optimal technique for quantifying left ventricular (LV) LGE extent remains lacking.

    Reproducibility of late gadolinium enhancement quantification techniques in ischemic and non-ischemic heart diseases (ReLate study) · 2025 · DOI

  • Stress cardiovascular magnetic resonance imaging (MRI) can be used to measure myocardial blood flow, detect coronary microvascular dysfunction and endotype individual patients, but evidence of clinical utility from randomized trials is lacking.

    Endotyping-informed therapy for patients with chest pain and no obstructive coronary artery disease: a randomized trial · 2025 · DOI

  • Background: Coronary slow flow (CSF) has gained significance as a chronic coronary artery disease, but few studies have integrated both biological and anatomical factors for CSF assessment.

    Establishment and verification of a nomogram that predicts the risk for coronary slow flow · 2024 · DOI

  • Background: The most appropriate tool for estimating the pretest probability (PTP) of obstructive coronary artery disease (CAD) in patients with diabetes mellitus (DM) and stable chest pain (SCP) remains unknown.

    Comparison of the RF-CL and CACS-CL models to estimate the pretest probability of obstructive coronary artery disease and predict prognosis in patients with stable chest pain and diabetes mellitus · 2024 · DOI

  • Background: Whether and how coronary artery calcium (CAC) progress contributes to cardiovascular outcomes has not been fully elucidated.

    Ten-year trajectory of coronary artery calcification and risk of cardiovascular outcomes: the Multi-Ethnic Study of Atherosclerosis · 2024 · DOI

  • The quantitative index of resting myocardial blood flow (MBF) has received little attention, and its manifestations and clinical value in the presence of unstable coronary blood flow have not been clarified.

    The diagnostic role of resting myocardial blood flow in STEMI patients after revascularization · 2024 · DOI

  • Nonetheless, preliminary clinical data indicate potential sensitivity of TRAFF2 mapping to myocardial infarction detection without the need for contrast agents, but off-resonance artifacts mitigation warrants further investigation.

    Feasibility of relaxation along a fictitious field in the 2nd rotating frame (TRAFF2) mapping in the human myocardium at 3 T · 2024 · DOI

  • Current clinical practice relies on monolithic, universal reference values. Applying criteria derived from younger, athletic populations to older adults risks missing cardiac sarcopenia. The study identifies a gap in the current understanding of biventricular volume and its relationship with body size and age.

    Detection of Biventricular Volume Increase in Overweight and Obese Individuals Using a Novel Index of the “Standard Human”—A Single-Center, Non-Contrast-Enhanced Cardiac CT Study · 2026 · DOI

  • Elevated Poisson-Gaussian noise in low-dose CT data. Residual cardiac and respiratory motion causing frame-to-frame misalignment. The need to preserve perfusion dynamics and maintain image characteristics relevant to diagnostic interpretation.

    Joint Denoising and Motion-Correction for Low-Dose CT Myocardial Perfusion Imaging Using Deep Learning · 2026 · DOI

  • Integrating the proposed framework with other quantitative perfusion estimation methods, - Exploring the application of the framework to other imaging modalities, - Investigating the use of other noise models and motion correction techniques

    Joint Denoising and Motion-Correction for Low-Dose CT Myocardial Perfusion Imaging Using Deep Learning · 2026 · DOI

  • Myocardial infarction detection is a challenging task. Cardiac MRI images can be complex and require expertise to interpret. Automated systems for myocardial infarction detection are needed.

    Deep Learning Framework for Myocardial Infarction Diagnosis from Cardiac MRI using Vision Transformers · 2026 · DOI

  • Future research should focus on improving the accuracy and reproducibility of automated AAC quantification. The development of more robust and reliable automated pipelines is needed.

    Quantification of Abdominal Aortic Calcification on CT: Clinical Validation for Assessment Of Cardiovascular Risk in Oncology · 2026 · DOI

  • The gap in the current literature is the lack of a benchmark for automated AAC tools against manual reference standards. There is a need for accurate and reproducible automated AAC quantification.

    Quantification of Abdominal Aortic Calcification on CT: Clinical Validation for Assessment Of Cardiovascular Risk in Oncology · 2026 · DOI

  • Future studies should investigate the mechanisms underlying the association between clinical risk factors and CSFP. Future studies should evaluate the effectiveness of strategies for preventing and managing CSFP. Future studies should consider the role of other clinical risk factors in the development of CSFP.

    Coronary slow flow phenomenon: a meta-analysis of clinical risk predictors · 2026 · DOI

  • The study identified a gap in the current understanding of the clinical risk factors associated with CSFP. The study highlighted the need for a comprehensive meta-analysis of the association between clinical risk factors and CSFP.

    Coronary slow flow phenomenon: a meta-analysis of clinical risk predictors · 2026 · DOI

  • The prevalence of CSF may be underreported due to the lack of objective diagnostic metrics. The impact of COVID-19 history on CSF is not well understood.

    Impact of COVID-19 history on the prevalence of coronary slow flow: a comparative study in unstable angina patients · 2026 · DOI

  • The current therapeutic paradigm for SCAD has limitations. There is a need for new therapeutic strategies that can promote plaque stabilization and reduce the risk of adverse cardiovascular events.

    Efficacy and safety of Shenqi Yangxin formula in patients with stable coronary artery disease based on CCTA: rationale, design, and study protocol for a randomized, double-blind, placebo-controlled study · 2026 · DOI

Most-cited papers in Cardiac Imaging and Diagnostics

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132 open questions have been extracted from the limitations and future-work passages of 446 Cardiac Imaging and Diagnostics papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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