End-to-end deep learning framework that predicts the procedural outcome of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) lesions directly from preprocedural coronary CT angiography, aiming to replace slower manual scoring systems (J-CTO, CT-RECTOR, KCCT). The pipeline first segments the coronary artery tree (Patch-UCTNet), detects candidate CTO lesions along the delineated vessel, extracts pathological lesion features with a Swin Transformer, and classifies two outcomes: successful guidewire crossing within 30 minutes and overall PCI success. In the original study, the model completed reconstruction and analysis 85% faster than manual scores (73.7s vs. 418-467s) and was more accurate than the manual CT-RECTOR, KCCT, and J-CTO_CCTA_ scores, reaching an AUROC of 0.97 on the internal test set and 0.96 on an independent external validation cohort (186 patients, 189 CTO lesions).

Largest federated cardiac CT analysis to date (n=8,104 scans) across a real-world federation of German university hospitals, addressing partially-labeled data across sites via a two-step semi-supervised knowledge-distillation strategy: task-specific CNNs first predict on unlabeled data per label type, then a SWIN-UNETR transformer learns from these predictions with label-specific heads. Learns a single federated model that simultaneously predicts TAVI-relevant landmarks (aortic hinge points, coronary ostia, membranous septum) and calcification from cardiac CT, improving generalizability over UNet-based baselines on downstream tasks.