Agatston 2.0 and AI-CVD unveiled in a new SCCT-hosted webcast, showcasing the next generation of calcium scoring and cardiometabolic imaging.

HOUSTON, TX, UNITED STATES, November 19, 2025 /EINPresswire.com/ -- The Society of Cardiovascular Computed Tomography (SCCT) and HeartLung.AI today announced the release of a new sponsored webcast, “Agatston 2.0: The next generation of calcium scoring in the era of AI-CAC and AI-CVD.” The free webcast, sponsored by HeartLung.AI, brings together Arthur Agatston, MD—creator of the Agatston Score—and members of HeartLung.AI’s Scientific Advisory Board to unveil Agatston 2.0 (AI-CAC), the evolution of the score that transformed preventive cardiology.

Over the past thirty years, coronary artery calcium (CAC) scoring has become the most powerful CT-based predictor of coronary heart disease (CHD) events. Yet two important limitations have constrained its clinical utility:
• “Power of Zero” exceptions. Although a CAC score of zero is strongly protective, CHD events still occur—particularly in younger individuals (<55 years) with a score of zero. these events are uncommon but clinically critical.
• Inability to monitor treatment. Because the traditional Agatston Score increases in both treated and untreated patients, repeat CAC scans cannot reliably guide therapy and are not recommended for monitoring.

How Agatston 2.0 / AI-CAC Addresses These Gaps
In the webcast, faculty explain how Agatston 2.0 (AI-CAC) eliminates the fixed 130-HU threshold by using a reference medium to correct for image noise and removes the historical 3 mm slice-thickness constraint. These advances allow detection of small and semi-calcified (“soft”) plaques that traditional CAC scoring often misses, substantially strengthening the “Power of Zero.”

In pooled analyses from MESA and the Framingham Heart Study, the 5-year CHD event rate in individuals with AI-CAC = 0 was below 0.05%. Given that a portion of CHD events (5–10%, especially in women) arises from microvascular disease rather than epicardial plaque, the few remaining events in the AI-CAC-zero group may be unrelated to coronary atheroma—bringing CT-based coronary anatomy close to its maximal predictive potential.

The webcast also details how Agatston 2.0 quantifies changes in plaque density, rather than only area or volume, enabling clinicians to monitor plaque progression and stabilization. Lower-density plaques confer higher risk, while increasing density reflects plaque stabilization and treatment benefit—opening the door to truly actionable serial CAC imaging.

AI-CVD: Beyond the Coronary Arteries
Building on AI-CAC, AI-CVD extends analysis far beyond the coronary arteries, transforming a standard CAC scan into a comprehensive, automated cardiometabolic assessment. Using the same scan currently obtained only to report a traditional Agatston Score, AI-CVD provides quantitative measurements of:
• Cardiac chamber volumes and left ventricular mass (for detecting LVH and predicting heart failure, atrial fibrillation, and stroke)
• Aortic wall and valve calcification
• Aortic and pulmonary artery dimensions
• Pericardial fat
• Thoracic muscle volume and myosteatosis
• Hepatosteatosis
• Osteopenia and osteoporosis
• Emphysema and interstitial lung abnormalities

Real-world cases, validation data, and workflow examples in the webcast illustrate how these measurements can be integrated into routine practice for AI-driven, multi-disease prevention.

One Unified Presentation, Delivered in Two Parts
Because of the SCCT webcast time limit, this program—originally delivered as a single continuous presentation—has been divided into two parts for online distribution. The content is unified and sequential, not a multi-topic “series.”
• Part 1 is hosted on the SCCT website (www.scct.org) and the SCCT YouTube channel.

• Part 2, which includes Dr. Arthur Agatston’s primary presentation, is hosted on the HeartLung website (www.heartlung.ai) and HeartLung’s YouTube channel.

This structure ensures SCCT members can access the program within the society’s webcast format while providing viewers with the full, unabridged content through HeartLung’s platforms. Viewers are encouraged to watch both parts to see the complete lecture, including Dr. Agatston’s talk and the full AI-CVD discussion.

The full two-part webcast, with direct links to both segments, can be accessed at:
https://www.heartlung.ai/post/heartlung-ai-webcast

Expert Faculty
“Agatston 2.0: The next generation of calcium scoring in the era of AI-CAC and AI-CVD” features a distinguished multidisciplinary faculty:

• Morteza Naghavi, MD
• Arthur Agatston, MD
• Thomas Atlas, MD
• Claudia I. Henschke, MD, PhD
• John Osborne, MD, PhD
• Anthony Reeves, PhD
• John Rumberger, MD, PhD
• Nathan D. Wong, PhD, MPH
• David F. Yankelevitz, MD

Together, these leaders in cardiology, radiology, imaging science, and preventive medicine trace the journey from the classic Agatston Score to today’s AI-enabled, whole-chest cardiometabolic imaging.

How to Watch
The webcast is available free of charge:
• Part 1: SCCT webcast platform at www.scct.org and the SCCT YouTube channel
• Part 2 and complete information: HeartLung.AI webcast page at
https://www.heartlung.ai/post/heartlung-ai-webcast, the HeartLung website (www.heartlung.ai), and HeartLung’s YouTube channel

About HeartLung AI

HeartLung.AI is a health-tech company aiming to bring AI-enabled early detection and prevention of cardiovascular disease and lung cancer to mass adoption. Additionally, the AI help physicians to opportunistically detect osteoporosis, fatty liver disease, and other cardiometabolic abnormalities such as myosteatosis. HeartLung Technologies Received FDA “Breakthrough” Designation and Marketing Authorization for AutoChamber™: The first AI that enables opportunistic detection of hidden heart disease in millions of chest CT scans. HeartLung cleared FDA 510(k) for AutoBMD which is the only DEXA-equivalent, CT-based opportunistic osteoporosis screening applicable to 25+ million CT scans of the chest and abdomen every year. HeartLung is awaiting approval for AI-CVD™ which includes multiple AI modules including AutoCAC™ (Automated Coronary Artery Calcium Scoring based on the legacy Agatston score) and AI-CAC ™ the new calcium scoring technique powered by AI, also referred to as “Agatston 2.0”. HeartLung is initially focused on opportunistic screening in chest CT scans as the lowest hanging fruit for preventive care. To use HeartLung.AI services no hardware or software installation is required—simply sign up within 5 minutes at www.provider.heartlung.ai and connect your PACS to HeartLung.AI cloud and receive AI-generated DICOMized PDF reports sent directly back to your PACS.
This seamless integration allows for immediate use without changing existing workflow. Additionally, referring physicians manually upload CT scans and receive instant AI-generated reports. Similar AI-CVD will empower hospitals and diagnostic imaging centers to provide their patients with fast, actionable data for multiple diseases all from a single chest CT scan.


HeartLung Technologies is positioned to lead the future of AI-enabled preventive imaging to fight the number 1 and 2 causes of death namely cardiovascular disease, and lung cancer. HeartLung’s innovations, including AI-CVD™, AI-CAC™, AutoChamber™, and AutoBMD™, are designed to empower hospitals and imaging centers with precision prevention technology at population scale.

About SCCT:
The Society of Cardiovascular Computed Tomography (SCCT) is the international professional society dedicated exclusively to advancing cardiovascular computed tomography (CCT). SCCT brings together physicians, scientists, and technologists from around the world to promote research, education, and clinical excellence in the use of cardiac CT for the prevention, diagnosis, and management of cardiovascular disease. Through evidence-based guidelines, accreditation programs, and educational initiatives, SCCT helps ensure high-quality, patient-centered cardiovascular CT practice globally.

About AI-CVD™

AI-CVD™ represents a paradigm shift in preventive imaging, unifying a suite of deep learning models into a single, cloud-enabled framework that transforms any chest CT—whether cardiac-gated or low-dose lung CT—into a multidimensional assessment of cardiometabolic health. Built on the nnU-Net and TotalSegmentator architectures, AI-CVD integrates nine validated modules—including AI-CAC (Agatston 2.0), AutoChamber™, AutoAorta™, AutoLiver™, AutoFat™, and AutoBMD™—to extract a full spectrum of structural and metabolic biomarkers from a single CT dataset. Unlike traditional cardiovascular imaging, which isolates one organ or disease at a time, AI-CVD generates a comprehensive “cardiovascular digital twin” that quantifies coronary calcium, cardiac chamber volumes, aortic and pulmonary artery dimensions, visceral and pericardial fat, liver steatosis, bone density, and lung parenchymal changes—all automatically and within minutes. The system’s modular design enables each biomarker to be used independently or combined for multivariate risk prediction, allowing clinicians to detect early signatures of heart failure, atrial fibrillation, COPD, diabetes, or osteoporosis long before symptoms emerge. Multiple peer-reviewed studies within the MESA and Framingham Heart cohorts have shown that AI-CVD–derived phenotypes outperform conventional clinical scores and biomarkers—including ASCVD, PREVENT, NT-proBNP, and CHA2DS2-VASc—in predicting future cardiovascular and metabolic events. FDA-cleared components such as AutoChamber™ (K240786) and AutoBMD™ (K213760) further validate its clinical readiness, ensuring reliability and regulatory compliance. By opportunistically analyzing scans already obtained for other indications, AI-CVD democratizes precision prevention—expanding the value of every chest CT from a single-organ diagnostic to a whole-body disease prevention platform. In doing so, AI-CVD transcends the limitations of traditional imaging by linking anatomical, metabolic, and functional data in one unified ecosystem, redefining how cardiovascular risk is detected, quantified, and managed.


About AI-CAC™

AI-CAC™, also referred to as Agatston 2.0, represents a major evolution in coronary calcium scoring by replacing the rigid, threshold-based approach of the traditional Agatston method with a deep learning–driven, fully automated, and quantitative analysis of coronary plaque characteristics. Whereas the Agatston score (Agatston 1.0) depends on arbitrary cutoffs—specifically calcium voxels exceeding 130 Hounsfield units with a minimum area of 1 mm²—AI-CAC eliminates these constraints, allowing it to detect even small, diffuse, or semi-calcified plaques that conventional scoring overlooks. Trained on thousands of annotated CT scans from cohorts such as MESA, AI-CAC calibrates each scan to its specific phantom reference, enabling intensity weighting and voxel-level quantification of calcium burden within anatomically segmented coronary arteries. This precision yields a continuous metric that captures the entire spectrum of calcific atherosclerosis, including sub-threshold or “soft” lesions that may precede visible calcification. In recent studies, AI-CAC reclassified nearly one in five individuals with an Agatston score of zero, identifying subtle plaque presence and revealing significantly higher long-term CHD risk among those with AI-detected calcium. Beyond sensitivity, AI-CAC introduces a hyperdensity index that differentiates metabolically stable, heavily calcified plaques from low-attenuation, high-risk lesions, thereby distinguishing treated versus untreated disease phenotypes and enabling longitudinal plaque monitoring. Combined with its near–real-time processing speed (˜15 seconds per scan) and compatibility with both gated and non-gated CT, AI-CAC democratizes calcium scoring for all clinically acquired chest CTs, making opportunistic cardiovascular screening practical at scale. In essence, AI-CAC preserves the prognostic legacy of the Agatston score while vastly expanding its sensitivity, reproducibility, and clinical utility—transforming every CT scan into a powerful tool for early detection, risk refinement, and preventive cardiology.

Marlon Montes
HeartLung Technologies
+1 310-510-6004
email us here

(Full Version) Agatston 2.0: The next generation of calcium scoring in the era of AI-CAC and AI-CVD

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