A Rad’s Eye View: Cardiac CT+ MR analysis bring greater confidence, clarity and speed

Artificial intelligence-enabled post-processing software is dramatically reducing cardiac imaging analysis times while improving consistency and collaboration between radiologists and cardiologists, according to Laura Dragonetti, MD, an internal medicine physician and radiologist from Buenos Aires, Argentina, who specializes in cardiovascular imaging with a focus on cardiac MR and cardiac CT.

Speaking about her experience using Circle Cardiovascular Imaging's cvi42 platform, Dragonetti says AI-assisted automation has transformed workflows for both cardiac magnetic resonance imaging (CMR) and coronary computed tomography angiography (CCTA), reducing analysis time from about 20 minutes per study to as little as one or two minutes for many cases.

 “Nowadays, a cardiac function analysis can be completed in around one or two minutes, or even with a single click in some cases," says Dragonetti who works across multiple institutions and serves as a consultant in cardiovascular imaging.

"The workflow now is clearly faster. I think cvi42 has increased my diagnostic confidence and reduced my report time by 70%, because the workflow is more organized and intuitive and the measurements are reproducible and clinical useful.”

- Laura Dragonetti, MD, Cardiovascular Imaging Radiologist, Buenos Aires, Argentina

While speed is a major advantage, Dragonetti says that comprehensive quantitative analysis remains the foundation of modern cardiac imaging. She says post-processing provides critical measurements, including ventricular volumes, ejection fraction, myocardial fibrosis, tissue mapping, blood flow and other quantitative parameters that are essential for diagnosis and patient management.

Those capabilities are particularly valuable in patients with cardiomyopathies, her primary clinical research interest.

"In cardiomyopathies, quantification and tissue characterization can change the way we understand the disease," Dragonetti says. "Today, thanks to modern software, it is much easier, faster and more reproducible."

Increased efficiency and confidence, she notes, allow imaging centers to perform more cardiac studies while expanding their cardiovascular imaging programs. She also sees quantitative imaging helping to bridge the longstanding communication gaps between radiologists and cardiologists.

Rather than relying on subjective descriptions, she notes that structured measurements create a common clinical language between radiologists and cardiologists. “It's very different to say I think the ventricle is dilated, as radiology often does,” she explains. “Compared to what cardiology says, that the left ventricular (LV) volume is this, the ejection fraction is this, the myocardial mass is this, the fibrosis pattern is this.”

Detailed CMR quantification detects disease much earlier

Among the software's capabilities, Dragonetti highlights ventricular function analysis, tissue characterization, T1 and T2 mapping, strain imaging and flow quantification as particularly valuable.

She cites her research involving patients with Fabry disease in Argentina that used CMR to evaluate left ventricular function, hypertrophy, myocardial mass and late gadolinium enhancement. The software enabled detailed assessment of myocardial involvement before and after contrast administration.

CMR can identify the characteristic fibrosis pattern in the inferolateral wall associated with Fabry disease even before left ventricular hypertrophy develops. Advanced mapping techniques further improve tissue characterization, allowing earlier disease detection. "For me, that is the real value of the software—confidence for research, confidence for follow-up and confidence for clinical decision-making," she says.

Combining CCTA and MRI increases the value of the software

Beyond CMR, Dragonetti says today's cardiovascular imaging increasingly integrates multiple modalities rather than treating CT and MRI as separate disciplines. She notes that cvi42 combines CT analysis, coronary plaque assessment, structural heart planning and AI-supported workflows within a single platform.

She also talks about the Society of Cardiovascular Computed Tomography's recent consensus statement on CT-derived fractional flow reserve (FFR-CT), which emphasizes the technology's role in improving diagnostic accuracy. As FFR-CT expands from academic medical centers into community hospitals, she says standardized analysis tools will become increasingly important.

"I think cardiovascular imaging is no longer separated by modalities," Dragonetti says. "We need to connect anatomy, function, tissue characterization, coronary disease, vascular disease and procedure planning."

"The most important impact is patient care," Dragonetti says. "The clinical team receives clear information for diagnosis, follow-up and treatment decisions."

Reflecting on her dual training in internal medicine and radiology, Dragonetti says quantitative cardiovascular imaging has fundamentally changed how she approaches patient care.

"Internal medicine taught me to understand the patient,” she says. “Radiology gave me the tools to see the disease. The software helped me move from I think I see it to I can measure it. That is the real value of technology.”