Fully Automated AI Aortic Measurements From MPI Attenuation CT Predict Mortality

In 29,339 pts, fully automated AI-derived aortic size index from MPI CT attenuation correction scans predicted all-cause mortality: ascending >2.2 cm/m2 HR 1.16 (1.07-1.26), descending >1.6 cm/m2 HR 1.23 (1.14-1.31), independent of perfusion defects.

• International multicenter cohort of 29,339 patients (median age 66, 56% male) undergoing SPECT/PET MPI across 10 centers, median follow-up 3.5 years.
• Prognostic value persisted after adjustment for age, sex, and perfusion abnormalities, suggesting an adjunctive risk biomarker without additional radiation or imaging.
• Retrospective design; outcome limited to all-cause mortality, not aortic-specific events.

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