Systematic review of AI for invasive coronary angiography analysis: progress and validation gaps

A systematic review of 134 studies on AI-based invasive coronary angiography analysis shows high internal accuracy for vessel segmentation and lesion assessment, but external validation remains limited. AI prediction of invasive physiology indices is a promising area.

• 134 studies included, covering tasks like vessel segmentation, lesion quantification, and prediction of physiological indices.
• Most studies demonstrate high internal performance but lack external validation; recent multi-center and prospective designs are emerging.
• AI prediction of invasive physiological indices is promising, but robust prospective evaluation is still needed.

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