Coronary disease & ACSDiagnostic or prognostic study

Myocardial Scar Assessment Using Artificial Intelligence-Powered Contrast-Free MRI

J Am Coll CardiolPublished

  • Diagnostic accuracy study
  • prospective
  • multicentre
  • blinded

Authors' conclusion

Accurate myocardial scar quantification can be achieved without contrast agents in high-quality and clear VNE images. VNE may triage the need for LGE and obviate its use in more than two-thirds of referrals for chronic myocardial infarction scar assessment without compromising diagnostic accuracy.

Study context

Population
Patients referred for cardiovascular magnetic resonance (CMR) myocardial scar assessment at 2 sites (Leeds and Fuwai)
Comparison
AI virtual native enhancement vs late gadolinium enhancement (LGE)
Outcome
Diagnostic performance of VNE in myocardial scar detection

Performance

As reported in the abstract

Diagnosis of MI
Test or modelAccuracy, confident images (n = 107)Accuracy, all images (n = 136)
Virtual native enhancement (VNE)94.4%87.5%

Further findings

Outcomemean difference (%) (95% CI)
Myocardial scar quantification, VNE vs LGE · correlation R = 0.903.2 (−10.4% to +16.8%)
OutcomeVNELGEEstimate
Clinical readers (4): VNE adequate without LGE
Patients VNE adequate69.7%Not reported in the abstract
Average diagnostic accuracy in these cases93.7%Not reported in the abstract
Diagnostic accuracy in these casesNot reported in the abstract93.9%

Agreement on infarcted myocardial territories

VNE-LGE agreement
90.0%

Original publication

Myocardial Scar Assessment Using Artificial Intelligence-Powered Contrast-Free MRI. J Am Coll Cardiol. Published 15 July 2026. doi:10.1016/j.jacc.2026.05.029

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