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A study to measure the utility of an AI-enhanced reporting tool in assisting busy CCTA readers with REPORT generation (SMART-REPORT).

July 3, 2026pubmed logopapers

Authors

O'Neal WT,Gudi H,Chandrasekhar M,Schumann C,Birch A,Mullen S,Ng N,Morris M

Affiliations (5)

  • Cone Health Heart & Vascular Center, 1220 Magnolia St, Greensboro, NC, 27401, USA. [email protected].
  • Banner University Medical Center Tucson, Tucson, AZ, USA.
  • Cone Health Heart & Vascular Center, 1220 Magnolia St, Greensboro, NC, 27401, USA.
  • Heartflow, Mountain View, CA, USA.
  • Banner Health, Phoenix, AZ, USA.

Abstract

This study aimed to determine if an integrated structured reporting (SR) tool incorporating results from artificial intelligence (AI) enabled coronary stenosis quantification (AI-CSQ), AI-enabled coronary plaque analysis (AI-CPA), and fractional flow reserve CT (FFR<sub>CT</sub>) can increase reader efficiency for coronary computed tomography angiography (CCTA), while reducing cognitive load. Eighty CCTAs from patients with stable chest pain or symptoms suggestive of coronary artery disease (CAD) were analyzed by five independent readers from two clinical sites. CCTA datasets were used to generate combined reports for AI-CSQ, AI-CPA, and FFR<sub>CT</sub>. Each reader randomly interpreted 40 cases with the SR tool (which provided a prepopulated fully editable template) and 40 cases without the SR tool using site-specific clinical workflows (400 total cases). Reporting times from initiation of case interpretation through report signing were measured with and without the SR tool and stratified by CAD-Reporting and Data System (CAD-RADS) 2.0 category. Reader confidence was recorded using a 5-point Likert Scale, and cognitive load (e.g., working memory load) was determined using a 9-point scale, with comparison by SR tool use. Inter-reader agreement associated with CCTA interpretation with versus without the SR tool also was compared. Reporting time per case was 40.2% shorter with versus without the SR tool (6.0 ± 2.0 vs. 10.0 ± 3.3 min; p < 0.001), independent of CAD-RADS 2.0 category. Readers were more likely to report very confident reads with the SR tool than without (48% vs. 29%; p < 0.001). Cognitive load also was significantly lower with the SR tool than without (3.8 ± 1.2 vs. 6.1 ± 1.5; p < 0.001). Report agreement was significantly higher with versus without the SR tool (94.6%±2.3% vs. 45.3%±9.2%; p < 0.001). The SR tool significantly improved reader efficiency and decreased work effort when interpreting comprehensive CCTA exams.

Topics

Journal Article

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