Valvular & structural heart disease

Automated Aortic Valve Calcification Scoring

JACC AdvPublished

Main finding · Pearson correlation and Bland-Altman analysis of algorithm-estimated vs manual Agatston scoresMean difference 5.2 AU 95% CI −7.6 to 17.9
  • Multicenter evaluation of a deep learning algorithm against expert reference standards
  • multicenter consortium of 33 sites spanning 8 health systems in the United States and Brazil
  • separate holdout test set acquired from 2021 to 2024
+2 more
  • multicenter consortium of 33 sites spanning 8 health systems in the United States and Brazil
  • separate holdout test set acquired from 2021 to 2024

Authors' conclusion

This automated deep learning algorithm quantifies AVC from routine chest CT with expert-comparable performance, potentially enabling opportunistic AS screening. Prospective studies are needed to determine whether it improves clinical outcomes.

Study context

Population
Patients undergoing nongated, noncontrast chest computed tomography (CT)Separate training, validation and holdout test sets · training 1,446 · validation 361 · holdout test set 239
Comparison
algorithm-estimated vs manual Agatston scores
Outcome
Pearson correlation and Bland-Altman analysis of algorithm-estimated vs manual Agatston scores

Main finding

As reported in the abstract

Pearson correlation and Bland-Altman analysis of algorithm-estimated vs manual Agatston scores

Mean difference

5.2 AU

95% CI −7.6 to 17.9

Algorithm vs Manual (expert reference standard)
mean difference 5.2 AU (95% CI −7.6 to 17.9)
Pearson correlation r
0.99

Secondary outcomes

OutcomeAlgorithmManual (expert reference standard)
Sensitivity and specificity for moderate-to-severe AS (sex-specific thresholds) · secondary outcome
sensitivity0.92 (95% CI: 0.80-0.97)Not reported in the abstractManual (expert reference standard): not reported in the abstract
specificity0.98 (95% CI: 0.95-0.99)Not reported in the abstractManual (expert reference standard): not reported in the abstract

Performance across demographic subgroups and CT technical parameters

Performance remained consistent across demographic subgroups and CT technical parameters

Original publication

Automated Aortic Valve Calcification Scoring. JACC Adv. Published 23 September 2026. doi:10.1016/j.jacadv.2026.103277

Summarised from the published abstract; every number is checked against it