While clinical guidance in many countries, including the U.S., U.K., and EU, recommends performing coronary CT angiography (CCTA) before other, more invasive procedures to diagnose coronary artery disease, interoperability challenges cause its use to vary among providers worldwide. Philips and its academic and nonacademic partners are seeking to change this with a recently awarded €6.5 million (over $7 million) grant to the company's public-private consortium, COMBINE-CT.

Earlier this month, the Innovative Health Initiative, an EU public-private partnership that funds health research and innovation, awarded the grant to the Philips consortium to support five multicenter clinical trials for determining and sharing best care practices around the use of CCTA in CAD diagnosis and treatment with providers worldwide, to create a more uniform approach.

“We want to deliver an automated, vendor-agnostic CCTA-enabled workflow to leverage the clinical insights from CCTA across the care pathway and make life easier for both patients and caregivers. We aim to provide results from the diagnostic work-up on CCTA to cardiologists preparing for a procedure, which they can perform in their office," Joke Orsel, clinical scientist, clinical informatics at Philips, told HCB News.

In doing this, cardiologists can upload patient information at the start of procedures to the cath lab, which will automatically populate the planning results and CCTA images.

Through the trials, Philips and its partners will look for ways to break down data silos among providers and hospital departments to decrease practice variation. They also will assess the unique supplementing information that can be extracted from spectral and spectral photon-counting CT images.

Here is what each trial will entail:

• The CODEX-1 trial: Will investigate the value of CT for definitive CAD diagnosis.


• The CONVENE trial: Will determine the clinical benefits of an end-to-end solution for CAD diagnosis, percutaneous coronary intervention planning, and the availability of CCTA-based insights inside the cath lab.


• The EVOLVE trial: Will evaluate the feasibility of CCTA-based follow-up for assessing the severity of atherosclerotic disease in high-risk diabetic patients.


• The ImpaCT trial: Will explore how noninvasive, low-resolution CCTA combined with high-resolution intracoronary imaging and AI improves stenosis grading and the detection of plaque and vulnerable plaque characteristics.


• The SPCCT-STENT trial: Will investigate how to assess coronary artery bypass grafts and the patency of previously implanted stents with photon-counting spectral CT.

The combination of multiple academic and nonacademic partners from different regions will allow the consortium to study how CCTA works best in different types of clinical settings to account for daily clinical practice when developing solutions.

Members include Philips, Université Lyon 1 Claude Bernard and its affiliate entity Hospices Civils De Lyon, Instituto de Investigación Biomédica de Salamanca, Amsterdam UMC location AMC, University Clinic Cologne, Medical Research Infrastructure Development and Health Services Fund by the Sheba Medical Center, Cardiologie Centra Nederland, Novo Nordisk, Consorcio Centro de Investigacion Biomedica en Red M.P., and EUPATI Foundation.

Each one will use their own CT scanners so that the CCTA workflow established is vendor-agnostic.

The results of the clinical trials will be published in international peer-reviewed journals and EUPATI (European Patient Organization).