{"doi":"10.1101/2025.11.14.25339933","title":"Ejection fraction quantification from ungated chest CT by AI","abstract":"Left ventricular ejection fraction (LVEF) is an important clinical metric, obtained by specialized imaging across the cardiac cycle. We present a novel AI approach to estimate LVEF from ungated chest CT. Using multicenter (11 sites) registry of 25,852 patients, AI-derived CT LVEF (AI LVEF) showed strong correlation with 3D gated positron emission tomography (r=0.84), area under the curve (AUC) of 0.96, negative predictive value of 95% for reduced LVEF (< 40%), and effectively stratified risk of heart failure, cardiovascular death, and all-cause death. In a separate large multicenter population (n=24,054) with lung CT scans, reduced AI LVEF was associated with a hazard ratio of 13.3 (95% confidence interval 9.7-18.4) for cardiovascular death. AI LVEF could also predict reduced echocardiographic LVEF (AUC=0.91). LVEF can be accurately estimated from non-contrast, ungated, low-dose chest CT scans, effectively stratifying patients for heart failure and mortality, with potential widespread clinical utility.","journal":"medRxiv","year":2025,"id":581687,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9609,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":259165,"name":"Jacek Kwieciński","orcid":"0000-0001-8202-6359","position":1,"is_corresponding":false},{"id":1225010,"name":"Aakash Shanbhag","orcid":"0000-0001-5199-3071","position":2,"is_corresponding":false},{"id":1049601,"name":"Konrad Pieszko","orcid":"0000-0002-5514-7750","position":3,"is_corresponding":false},{"id":1223349,"name":"Giselle Ramirez","orcid":null,"position":4,"is_corresponding":false},{"id":1084549,"name":"Mark Lemley","orcid":"0000-0002-1531-880X","position":5,"is_corresponding":false},{"id":979232,"name":"Aditya Killekar","orcid":"0000-0003-3831-5676","position":6,"is_corresponding":false},{"id":957757,"name":"Waseem Hijazi","orcid":"0000-0003-1511-9605","position":7,"is_corresponding":false},{"id":316500,"name":"Robert J.H. 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