Determine whether CT-based or MRI techniques will prevail as the single non-invasive modality for comprehensive coronary assessment

Determine whether Computed Tomographic Coronary Angiography (CTCA) or Magnetic Resonance Angiography (MRA) will ultimately provide superior performance to serve as a single non-invasive, safe, and convenient modality for comprehensive diagnostics, risk management, and treatment decisions in coronary artery disease, accounting for trade-offs such as radiation exposure (CT), spatial and temporal resolution, motion artefacts, scan time, cost, accessibility, and patient contraindications (MRI).

Background

Within the discussion of non-invasive imaging options for coronary artery disease, the paper contrasts CTCA and MRA. CTCA currently offers higher spatial resolution and broader availability but involves ionizing radiation and contrast use, whereas MRA is radiation-free and offers functional assessment but remains limited by lower spatial/temporal resolution, longer scan times, motion artefacts, higher cost, and accessibility constraints. Emerging AI and hardware advances (e.g., photon-counting CT, CSAI for MRA) may shift this balance.

The authors explicitly note that it remains an unresolved question which modality will ultimately prevail as the comprehensive single-modality solution for diagnostics, risk stratification, and treatment planning, highlighting a clinically meaningful and technology-dependent open problem.