Philips’ COMBINE-CT Project Moves into Clinical Validation Stage

Philips announced that its COMBINE-CT project has moved from technology development to clinical validation of its CT-based integrated care pathway for coronary artery disease (CAD) patients.

The four-year project, which began in 2023, is a Philips-coordinated European consortium that aims to transform coronary CT angiography (CCTA) from a diagnostic test into an AI-enabled platform to support clinical decisions and plan treatments. COMBINE-CT is building a connected, automated CCTA workflow to support the CAD care pathway, from treatment selection and intervention planning to procedural guidance and follow-up.

The initiative marries experts in cardiology, medical imaging, interventional procedures and AI, alongside health economists and non-profit organizations representing patients. Five multicenter studies will assess CCTA’s role in definitive CAD diagnosis, treatment planning, procedure guidance, and follow-up.

The studies will also explore how spectral, photon-counting CT can help evaluate coronary artery bypass grafts and previously implanted stents:

1. CONVENE will evaluate the consortium’s end-to-end CCTA-based diagnostic and interventional workflow.
2. CODEX-1 will determine the accuracy and reproducibility of the diagnostic AI-based software on CCTA, on data from over 1,000 patients.
3. IMPACT will leverage invasive coronary angiography, invasive coronary physiology measurements and intracoronary imaging to improve the diagnostic accuracy of non-invasive AI-enhanced CCTA for stenosis grading, plaque burden and composition, and non-invasive coronary physiology.
4. SPCCT-STENT will study patients receiving non-invasive follow-up with Spectral Photon Counting CT (SPCCT) CCTA after high-risk and complex PCI treatment. SPCCT provides advanced medical imaging based on energy-resolving detector technology, aimed to provide superior imaging of stents and surrounding tissue.
5. EVOLVE will evaluate the feasibility of using serial non-invasive, AI-enriched CCTA imaging to identify novel imaging features associated with plaque progression to improve individualized risk prediction in high-risk patients with type 2 diabetes mellitus.

The IHI COMBINE-CT public-private partnership brings together 11 partners from six European countries for a four-year project with a €10 million budget. The initiative is co-funded by industry partners through in-kind contributions and additional resources, along with the European Union’s Innovative Health Initiative (IHI). Partners include Philips and Novo Nordisk, clinical and academic institutions across the Netherlands, France, Israel, Spain, and Germany, and pan-European nonprofit EUPATI.

Comments from Philips exec and clinician

Bert van Meurs, chief business leader Diagnosis and Treatment, Image Guided Therapy: “AI-powered CT imaging is creating new opportunities for the non-invasive diagnosis and assessment of coronary artery disease while enabling more informed treatment decisions. By combining AI, spectral CT and minimally invasive therapies, our joint research aims to help physicians diagnose and treat coronary artery disease with greater precision, confidence and efficiency.”

Dr. Bimmer Claessen, interventional cardiologist, Amsterdam UMC: “Interventional cardiologists need precise and actionable information to plan and deliver the most appropriate treatment for each patient with coronary artery disease. We are researching how combining AI, CT and interventional X-ray imaging could enhance PCI procedures to treat coronary artery disease. Through the COMBINE-CT project, we aim to make this information readily available whenever it is needed – before, during and after the procedure—helping physicians make informed decisions with greater confidence, even in highly dynamic situations.”