In this solo presentation, Dr. John Osborne, Chief Medical and Scientific Officer at Clear Cardio, explains how artificial intelligence (AI) augments cardiac CT imaging to reveal, quantify, categorize, and longitudinally track coronary and carotid plaque—information that traditional imaging cannot provide. He uses an "AI glasses" analogy to illustrate how AI extracts over 2,000 shades of gray from CT data, far beyond the 50 shades visible to the naked eye. Osborne describes Clear Cardio’s primary AI partner, Cleerly, highlighting its validation against multiple invasive imaging modalities (quantitative angiography, OCT, IVUS, near‑infrared spectroscopy) and its unique ability to monitor plaque regression or progression over time. He then compares other AI platforms: HeartFlow (adds blood‑flow modeling but less validated for plaque), Caristo (measures vascular inflammation via the Fat Attenuation Index), and Elucid (FDA‑cleared carotid plaque analysis). Throughout, he emphasizes the clinical value of AI‑derived plaque metrics for assessing treatment efficacy, personalizing risk management, and guiding preventive strategies. The talk concludes with a call to action for viewers to schedule a Clear Cardio assessment and a promise to stay at the forefront of emerging AI tools.
Chapters
What AI allows us to do is literally see plaque that we cannot see with our eyes. They're actually encoded and coming out of the CT machine with over 2,000 shades of gray. As I like to explain, without my glasses, I can see red, green, and blue. I put on my fancy AI glasses, now I can see red, green, blue, infrared, ultraviolet, X-rays, gamma rays, radar waves, or basically analogous to the entire electromagnetic spectrum that was sitting in the data, but we're— our eyes just couldn't see it. Hey everybody, this is Dr. John Osborne, the Chief Medical and Scientific Officer at Clear Cardio. Thanks again for joining us, and today we're going to talk about something that many people ask about, is the various AI programs, artificial intelligence programs, that we use once we do the cardiac CT to further allow us to dive much deeper into that data, literally see things that we cannot see with our eyes, be able to quantify those things very accurately, literally measuring how much plaque you have in your heart, what kinds of plaque, categorize that plaque— hard plaque, soft plaque, and other kinds of plaque. That all becomes critical. And also, this is another thing that AI allows us to do, not only see plaque that we could not see, measure that plaque very accurately, categorize those different kinds of plaque, all of which the AI allows us to do, but then be able to track that plaque over time, which until we had cardiac CT and AI was an impossible question. So if you had a heart attack or stents or balloons or surgery and you had your heart therapy and you do whatever your doctor tells you to do, down the road if you said, well, gee, doc, you know, I'm doing all things you asked me to do, I'm taking medications, I lost weight, I'm not smoking, or Whatever might be relevant to the individual patient, and say, "Well, that's great, but and I'm taking your medications. My numbers are better. My blood pressure is better. My cholesterol is better. Whatever. But if you were to ask your doctor, is my plaque better? Up until we had cardiac CT and AI, that was not an answerable question because we had no way of understanding where you came from, how much plaque you had, what kind of plaque, what category plaque you have. All of the stuff that we can derive from AI now added on to your cardiac CT, which now makes AI an irreplaceable tool. I've been doing cardiac CT for over 25 years. Over 25,000 patients. But I will say that cardiac CT up until about 6 years ago was pretty much it. We looked at pictures and we did our best in sort of an analog, non-AI way. What AI allows us to do is literally see plaque that we cannot see with our eyes. I always love to say how that compares to our looking at cardiac CT images with and without AI. When we add AI, and here's my analogy, with cardiac CT we can see about 50 shades of gray from black to white, and that's where the plaque is. The 50 shades of gray between black white on our CT images. However, all of those millions of pixels that make up those pictures of the heart are not encoded with 50 shades of gray. They're actually encoded and coming out of the CT machine with over 2,000 shades of gray. So what AI allows us to do is, as I like to explain, without my glasses I can see red, green, and blue. I put on my fancy AI glasses, now I can see red, green, blue, infrared, ultraviolet, X-rays, gamma rays, radar waves, or basically analogous to the entire electromagnetic spectrum that was sitting in the data but our eyes just couldn't see. Here at Clear Cardio, we use one form of AI called Clearly. Clearly really was the leader of the pack, the first to come out with a plaque— AI plaque analysis program. It has been validated and calibrated versus many different imaging technologies we use, from quantitative angiography to something called OCT, optical coherence tomography, to something called IVUS, intravascular ultrasound, even to something called near-infrared spectroscopy, particularly useful to see those soft lipid-rich plaques. Plaques as well. So it was the first to market, the first AI platform to add on to cardiac CT images to be able to allow us to have our AI glasses on to be able to look at, measure, detect, and track plaque. So that's why we generally use Clearly as our AI partner to be able to really extract all of this data from the coronaries. There are other companies out there, obviously, after Clearly started out this process and this concept of using AI to extract all that data from the heart, other companies have come into play as well. Another large company, these two companies are probably the major leaders in this, but there are a bunch of other companies too. But the other major leader is a company called HeartFlow. Another good product. They initially started out to measure blood flow in the blood vessels. Now, not only can they allow us to see, measure, detect plaque, and track plaque over time, but we can also derive the blood flow down the vessels and see if there's a blockage in the vessel. HeartFlow started out as a blood flow company. HeartFlow then developed a plaque analysis program, which they also have. I would argue not as well validated against some of the other different ways that we historically used to measure plaque very accurately, but Cleerly has really been the leader in plaque analysis and understanding plaque, measuring plaque. Also, another thing that Cleerly does that nobody else has at this point is the ability to track plaque over time, then over time track that plaque. So that's another feature that Cleerly has that the other companies don't yet have, which is why we like Cleerly. Want clarity on your arterial risk? Click now the link in the description to schedule your Clear Cardio patient assessment call. We'll review your risk factors, see if our advanced program fits you or points you in the right direction. So different ways of measuring, looking at plaque. Our standard, our gold kind of gold standard is clearly, but there are other companies and we're always constantly looking at the technology. We go where the technology is. So that doesn't mean that, you know, we're not wedded to any one particular AI technology. And if better, newer technologies come to fore and are scientifically proven and show an advance, then that's what we'll use. That's where Clear Cardio is going to go as well. There are some other companies that don't really look at plaque per se. They're looking at inflammation in the vessels. This is called FAI, or Fat Attenuation Index, or Plaque-Associated Index. So it's kind of looking not at blockages or plaque per se, but it's looking to see if the vessels are inflamed. That product from a company called Caristo just got approved by the FDA, so we will have that too. So yet another whole different way of looking at plaque and the evolution of plaque and getting a handle on Are the vessels sticky or not, the way I like to put it. But again, we constantly look at all the new data, all the new tools that come out. If there's a better tool that offers better technology based on better science or better imaging, obviously at Cleer Cardio, that's where we're going to go. There's another tool I'll mention that we use for the carotid imaging. So only one company has an FDA-cleared carotid analysis plaque using AI for the carotids. That company is called Elucid. We work with them. We're one of the first people to offer that as well. So we use Elucid. Which uses a little different technology, but applying again AI to the carotid imaging. So now what we can do is we can take the images of the heart, the same IV bolus of contrast, follow that bolus, as we call it, that contrast up into the neck. So we can do the heart, do the neck, as far as you're concerned, it all happens in a few seconds. And then we can analyze with Cleerly AI the heart and then use the product from Elucid to analyze carotid arteries. So lots of great evolving tools. I'm sure we'll keep you up to date as all of these tools continue continue to evolve. And at Clear Cardio, we are wedded to the best tool available for you to really understand, monitor, track progression, but more importantly, even better, track regression of plaque. So as these tools continue to evolve, we of course at Clear Cardio will be leading the way in the implementation of these tools. But that's just a little bit of background as far as some of the different tools that we use on a daily basis for AI to look at the heart. And then again, over the last year, now we can apply AI analysis for quantitative plaque analysis to the carotids as well. So We will continue to evolve. Just a brief overview of some of the companies and platforms out there in these— this AI space, and, uh, we will keep you at the state of the art and the state of the heart as all of these technologies continue to evolve. Again, this is Dr. John Osborne, the Chief Medical and Scientific Officer at Clear Cardio. Thanks for listening, and we will continue to keep you at the state of the art, and power is prevention. Don't miss this other episode right here on the screen where we will reveal the missing answers you need to know about true cardiovascular prevention. And if you're ready for absolute clarity on your arterial risk, click the link in the description to schedule your Clear Cardio patient assessment. We'll look at your specific risk factors and see if our advanced program can help you.
