Data Show AI Software Can Quantify Key Drivers of Heart Attack, Stroke From CT

Elucid, a medical technology company developing AI software for physicians to optimize the treatment of patients with known or suspected vascular disease, is touting studies that demonstrate computed tomography angiography (CTA) analysis capabilities are expanded through its AI software, ElucidVivo. The company’s technology can objectively quantify intraplaque hemorrhage (IPH) and lipid-rich necrotic core (LRNC) as well as automatically determine histologically defined plaque stability phenotypes across all epicardial vessels, according to the data.
 
Prior to utilizing Elucid’s AI software, CTA has been increasingly used in the diagnosis of vascular disease. However, in the study “Intraplaque Hemorrhage and Lipid-Rich Necrotic Core may be Objectively Quantified using Histopathologic Correlates Automatically from CTA,” delineation of IPH is reported for the first time by any software. Adding to the current clinically labelled ability to accurately delineate LRNC, the method is able to discriminate between the two effectively. Blinded to histology, CTA was analyzed using the ElucidVivo software (previously known as vascuCAP) and provided results that agreed with histopathologic references and linearity of both tissue types independently. Results indicated that LRNC and IPH may be quantitatively measured from routinely available CTA, which increases its diagnostic power and expands the landscape of clinical decision support tools for tailored therapeutics.

“These [data] shed light on the meaningful clinical value of scientific cardiovascular imaging when strong concordance with histopathology is confirmed,” said Matthew Budoff, M.D., program director and director of Cardiac CT, Division of Cardiology, Harbor-UCLA Medical Center. “There is potentially strong prognostic value in automatically identifying these elusive plaque features and categorizing patients which may finally help us start to finally reduce stroke and heart attack rates.”
 
In the study titled, “Histologically Defined Plaque Stability Phenotype Can Be Reliably Determined Automatically from CTA Across All Epicardial Vessels in One Acquisition,” the ElucidVivo software was used to determine lesion stability from CTA, validated by histology, based on its accurate tissue classification. Long considered a “holy grail” of medicine, the ability to identify vulnerable plaque by any modality, invasive or otherwise marks a landmark capability for patients that have historically been at risk for adverse events such as sudden cardiac death. Results showed classification measured against ex vivo data was more than sufficient for clinical use and was able to determine plaque stability efficiently. Previous studies have demonstrated the increased prevalence of unstable plaques post-mortem, but performing this characterization from non-invasive imaging for the first time enables widespread usage to predict and prevent adverse events, such as heart attack and stroke. Moreover, unlike catheter-based methods, not only were multiple tissue types reliably characterized, but this type of assessment was performed systematically rather than only focally to optimize patient care, so that care may reach the goal of understanding the “vulnerable patient”, even beyond individual vulnerable plaques.
 
“By applying our software’s machine intelligence, we are, for the first time, able to accurately assess plaque stability from routine, non-invasive radiologic images. Our goal remains to provide a precise diagnosis and guide treatments for the world’s leading cause of death,” said Elucid Founder Andrew Buckler. “This will further the options available for medical analysis to improve both patient and medical teams’ experiences.”

Elucid is a Boston-based medical technology company using uniquely interpretable and validated AI to provide physicians with a cost-effective means to optimize treatment decisions for patients with known or suspected cardiovascular disease. Advanced clinical insights from ElucidVivo equip physicians with critical information designed to enable precision medicine. ElucidVivo is the first U.S. Food and Drug Administration-cleared and CE-marked non-invasive software to quantify atherosclerotic plaque characteristics compared to histopathology, including Lipid Rich Necrotic Core, and derives fractional flow reserve based on the vasodilative capacity of the vessel wall. This unique information informs better treatment decisions by physicians leading to better patient outcomes, improved quality of care, and reduced healthcare costs. The ElucidVivo software is available for commercial use in the United States and Europe.