Coronary CT-derived fractional flow reserve (CT-FFR) is a noninvasive alternative to invasive FFR for assessing the hemodynamic significance of coronary artery stenosis. CT-FFR uses routinely acquired coronary CT angiography (CCTA) with artificial intelligence and computational fluid dynamics to estimate pressure gradients, thereby supporting clinical decisionmaking without procedural risk. Adoption and implementation vary widely across regions. In Asia, South Korea exclusively uses HeartMedi+, which enables rapid analysis, streamlined workflow integration, and high user satisfaction. Japan relies primarily on FFR CT, which has national reimbursement and significantly influences treatment strategies, reducing unnecessary invasive procedures. Hong Kong, Singapore, Taiwan, Thailand, and Vietnam remain in early or exploratory phases due to cost, reimbursement, and infrastructure barriers. In the United States, CT-FFR is guideline-endorsed and reimbursed, where HeartFlow is the most widely used, supported by robust clinical validation and outcome data. Despite regional variability, CTFFR offers a noninvasive solution that enhances patient management, reduces unnecessary invasive testing, and is poised for broader clinical integration as technology and validation advance.

The Asian Society of Cardiovascular Imaging-Practical Tutorial (ASCI-PT) is an instructional initiative of the ASCI School designed to enhance educational standards. In 2021, the ASCI-PT was convened with the goal of formulating a consensus statement on the assessment of coronary stenosis and coronary plaque using coronary CT angiography (CCTA). Nineteen experts from four countries conducted thorough reviews of current guidelines and deliberated on eight key issues to refine the process and improve the clarity of reporting CCTA findings. The experts engaged in both online and on-site sessions to establish a unified agreement. This document presents a summary of the ASCI-PT 2021 deliberations and offers a comprehensive consensus statement on the evaluation of coronary stenosis and coronary plaque in CCTA.

Background: Suicide remains a significant global public health challenge, with hanging as the most prevalent suicide method in South Korea. This study aimed to determine diagnostic markers confirming suicidal hanging-associated deaths. Methods: In this prospective study, hemorrhages at the periosteal-clavicular origin of the sternocleidomastoid (SCM) muscles were compared among suicidal hanging, manual strangulation, and ligature strangulation cases. This study included 211 cases of suicide by hanging, and a control group of 50 individuals who underwent cardiopulmonary resuscitation but died of other causes. Additionally, nine cases of ligature strangulation and six cases of manual strangulation were analyzed. Postmortem examinations were conducted, and clavicular hemorrhages were histologically evaluated. Statistical analyses were performed using the χ2 test. Results: Hemorrhages at the periosteal-clavicular origin of the SCM were observed in 178 of the 211 hanging cases (84.4%). The highest frequency of clavicular hemorrhage was found in typical hanging cases with complete suspension. Among the 50 control cases, only three showed hemorrhages in the clavicular region, but these were extravasations in the adjoining soft tissue, not in the periosteum. In cases of manual and ligature strangulation, SCM hemorrhages were found within the muscle tissue and were not of periosteal-clavicular origin. Conclusion Hemorrhage at the periosteal-clavicular origin of the SCM is a significant finding in suicidal hanging and serves as a potential pathognomonic marker for confirming cases of suicidal hanging. The study revealed a statistically significant association between the type of hanging, completeness of body suspension, and the occurrence of these hemorrhages.Cardiopulmonary resuscitation does not cause a hemorrhage at this location.

Coronary artery disease (CAD) narrows vessel lumens at the sites of atherosclerosis, increasing the risk of myocardial ischemia or infarction. Early and accurate diagnosis of CAD is crucial to significantly improve prognosis and management. CT angiography (CTA) is a noninvasive imaging technique that enables assessment of vascular structure and stenosis with high resolution and contrast. Coronary CTA is useful in the diagnosis of CAD. Recently, the CAD-reporting and data system (CAD-RADS), a diagnostic classification system based on coronary CTA, has been developed to improve intervention efficacy in patients suspected of CAD. While the CADRAD is based on CTA, it includes borderline categories where interpreting the coronary artery status solely based on CTA findings may be challenging. This review introduces CTA findings that fall within the CAD-RADS categories that necessitate additional tests to decide to perform invasive coronary angiography and discusses appropriate management strategies.

Background: Suicide remains a significant global public health challenge, with hanging as the most prevalent suicide method in South Korea. This study aimed to determine diagnostic markers confirming suicidal hanging-associated deaths. Methods: In this prospective study, hemorrhages at the periosteal-clavicular origin of the sternocleidomastoid (SCM) muscles were compared among suicidal hanging, manual strangulation, and ligature strangulation cases. This study included 211 cases of suicide by hanging, and a control group of 50 individuals who underwent cardiopulmonary resuscitation but died of other causes. Additionally, nine cases of ligature strangulation and six cases of manual strangulation were analyzed. Postmortem examinations were conducted, and clavicular hemorrhages were histologically evaluated. Statistical analyses were performed using the χ2 test. Results: Hemorrhages at the periosteal-clavicular origin of the SCM were observed in 178 of the 211 hanging cases (84.4%). The highest frequency of clavicular hemorrhage was found in typical hanging cases with complete suspension. Among the 50 control cases, only three showed hemorrhages in the clavicular region, but these were extravasations in the adjoining soft tissue, not in the periosteum. In cases of manual and ligature strangulation, SCM hemorrhages were found within the muscle tissue and were not of periosteal-clavicular origin. Conclusion Hemorrhage at the periosteal-clavicular origin of the SCM is a significant finding in suicidal hanging and serves as a potential pathognomonic marker for confirming cases of suicidal hanging. The study revealed a statistically significant association between the type of hanging, completeness of body suspension, and the occurrence of these hemorrhages.Cardiopulmonary resuscitation does not cause a hemorrhage at this location.

Coronary artery disease (CAD) narrows vessel lumens at the sites of atherosclerosis, increasing the risk of myocardial ischemia or infarction. Early and accurate diagnosis of CAD is crucial to significantly improve prognosis and management. CT angiography (CTA) is a noninvasive imaging technique that enables assessment of vascular structure and stenosis with high resolution and contrast. Coronary CTA is useful in the diagnosis of CAD. Recently, the CAD-reporting and data system (CAD-RADS), a diagnostic classification system based on coronary CTA, has been developed to improve intervention efficacy in patients suspected of CAD. While the CADRAD is based on CTA, it includes borderline categories where interpreting the coronary artery status solely based on CTA findings may be challenging. This review introduces CTA findings that fall within the CAD-RADS categories that necessitate additional tests to decide to perform invasive coronary angiography and discusses appropriate management strategies.

The Asian Society of Cardiovascular Imaging-Practical Tutorial (ASCI-PT) is an instructional initiative of the ASCI School designed to enhance educational standards. In 2021, the ASCI-PT was convened with the goal of formulating a consensus statement on the assessment of coronary stenosis and coronary plaque using coronary CT angiography (CCTA). Nineteen experts from four countries conducted thorough reviews of current guidelines and deliberated on eight key issues to refine the process and improve the clarity of reporting CCTA findings. The experts engaged in both online and on-site sessions to establish a unified agreement. This document presents a summary of the ASCI-PT 2021 deliberations and offers a comprehensive consensus statement on the evaluation of coronary stenosis and coronary plaque in CCTA.

Background: Suicide remains a significant global public health challenge, with hanging as the most prevalent suicide method in South Korea. This study aimed to determine diagnostic markers confirming suicidal hanging-associated deaths. Methods: In this prospective study, hemorrhages at the periosteal-clavicular origin of the sternocleidomastoid (SCM) muscles were compared among suicidal hanging, manual strangulation, and ligature strangulation cases. This study included 211 cases of suicide by hanging, and a control group of 50 individuals who underwent cardiopulmonary resuscitation but died of other causes. Additionally, nine cases of ligature strangulation and six cases of manual strangulation were analyzed. Postmortem examinations were conducted, and clavicular hemorrhages were histologically evaluated. Statistical analyses were performed using the χ2 test. Results: Hemorrhages at the periosteal-clavicular origin of the SCM were observed in 178 of the 211 hanging cases (84.4%). The highest frequency of clavicular hemorrhage was found in typical hanging cases with complete suspension. Among the 50 control cases, only three showed hemorrhages in the clavicular region, but these were extravasations in the adjoining soft tissue, not in the periosteum. In cases of manual and ligature strangulation, SCM hemorrhages were found within the muscle tissue and were not of periosteal-clavicular origin. Conclusion Hemorrhage at the periosteal-clavicular origin of the SCM is a significant finding in suicidal hanging and serves as a potential pathognomonic marker for confirming cases of suicidal hanging. The study revealed a statistically significant association between the type of hanging, completeness of body suspension, and the occurrence of these hemorrhages.Cardiopulmonary resuscitation does not cause a hemorrhage at this location.

Coronary artery disease (CAD) narrows vessel lumens at the sites of atherosclerosis, increasing the risk of myocardial ischemia or infarction. Early and accurate diagnosis of CAD is crucial to significantly improve prognosis and management. CT angiography (CTA) is a noninvasive imaging technique that enables assessment of vascular structure and stenosis with high resolution and contrast. Coronary CTA is useful in the diagnosis of CAD. Recently, the CAD-reporting and data system (CAD-RADS), a diagnostic classification system based on coronary CTA, has been developed to improve intervention efficacy in patients suspected of CAD. While the CADRAD is based on CTA, it includes borderline categories where interpreting the coronary artery status solely based on CTA findings may be challenging. This review introduces CTA findings that fall within the CAD-RADS categories that necessitate additional tests to decide to perform invasive coronary angiography and discusses appropriate management strategies.

Background: Suicide remains a significant global public health challenge, with hanging as the most prevalent suicide method in South Korea. This study aimed to determine diagnostic markers confirming suicidal hanging-associated deaths. Methods: In this prospective study, hemorrhages at the periosteal-clavicular origin of the sternocleidomastoid (SCM) muscles were compared among suicidal hanging, manual strangulation, and ligature strangulation cases. This study included 211 cases of suicide by hanging, and a control group of 50 individuals who underwent cardiopulmonary resuscitation but died of other causes. Additionally, nine cases of ligature strangulation and six cases of manual strangulation were analyzed. Postmortem examinations were conducted, and clavicular hemorrhages were histologically evaluated. Statistical analyses were performed using the χ2 test. Results: Hemorrhages at the periosteal-clavicular origin of the SCM were observed in 178 of the 211 hanging cases (84.4%). The highest frequency of clavicular hemorrhage was found in typical hanging cases with complete suspension. Among the 50 control cases, only three showed hemorrhages in the clavicular region, but these were extravasations in the adjoining soft tissue, not in the periosteum. In cases of manual and ligature strangulation, SCM hemorrhages were found within the muscle tissue and were not of periosteal-clavicular origin. Conclusion Hemorrhage at the periosteal-clavicular origin of the SCM is a significant finding in suicidal hanging and serves as a potential pathognomonic marker for confirming cases of suicidal hanging. The study revealed a statistically significant association between the type of hanging, completeness of body suspension, and the occurrence of these hemorrhages.Cardiopulmonary resuscitation does not cause a hemorrhage at this location.