Jupiter Medical Center has taken the guesswork out of assessing patients for coronary heart disease by combining specialized imaging and artificial intelligence (AI) software that allows doctors to see, measure, and understand what’s happening inside of blood vessels in striking detail.
Advances in diagnostic technology are critical for the well-being of those who may be at risk for heart disease to stave off the risk. Heart disease remains the leading cause of death in the United States, according to the Centers for Disease Control and Prevention (CDC), accounting for more than 683,000 deaths in 2024. Coronary artery disease—or narrowing of the heart’s blood vessels due to cholesterol build up, debris, and calcium—is the most common type. About one in 20 adults has coronary artery disease, and in the United States, someone has a heart attack about every 40 seconds, according to the CDC.
Using a new form of imaging paired with artificial intelligence, physicians can now see not only whether a coronary artery is narrowed, but also by how much, what it is comprised of, and whether it is affecting the blood flow. The result is a more detailed picture of heart disease, one that can help doctors decide who may need additional diagnostic studies, who may need a procedure—and who may be able to avoid one.
Cleerly is the new AI software that aids doctors at Jupiter Medical Center. It is approved by the Food and Drug Administration to analyze images created from coronary computed tomography angiography (CCTA), a specialized non-invasive imaging study of the heart’s blood vessels.
A CCTA scan uses CT imaging and contrast dye to create detailed pictures of the arteries that supply blood to the heart. Cleerly’s analysis can build a 3D model of the arteries, identify and quantify plaque, and measure narrowing to assess the likelihood that ischemia (reduced blood flow to a part of the heart) is present. It can also characterize plaque as calcified, noncalcified, or mixed. Essentially, it helps doctors to evaluate the disease process more precisely, so clinical intervention can occur before it becomes a life-threatening emergency.
Dr. Lee Fox has watched this technology grow. Fox is the chief of staff at Jupiter Medical Center and is board certified in vascular and interventional radiology and diagnostic radiology. He began wor ing with coronary CCTA in 2004, when these types of scans marked a major advancement. Now, he sees Cleerly as the next step. “The technology has evolved tremendously since that time,” Fox says. “This is the next iteration”.
For Fox, the value begins with precision. A radiologist can look at a CCTA and identify plaque and narrowing, but some measurements are difficult to make with the human eye alone. Cleerly applies an AI algorithm to the images and can provide a more precise evaluation of the arteries. It can estimate the percentage of plaque and composition more accurately.
Fox says it can also quantify the overall volume of plaque, something he describes as very difficult and perhaps impossible to do visually. Heart disease is not only about whether a single artery has reached a certain dramatic level of blockage. It is also about how much plaque exists throughout the coronary arteries, where it is located, and what it is made of. “What that means for a patient is not only are they getting a better overall idea of the disease but also how dangerous it may be,” Fox says.
That distinction can be crucial. Some plaque is calcified and stable, more like a rock sitting in the arterial wall. Other plaque is soft, full of cholesterol and debris, which can be more concerning because it can rupture and trigger a heart attack. Fox describes the frightening scenario many people associate with sudden cardiac events: a person who seemed fine until a silently progressing buildup of dangerous plaque suddenly broke apart.
Cleerly may sound technical, but it’s basically providing a clear understanding of what has been quietly building for years in the coronary arteries. And the goal is simple. Find the disease earlier. Understand it better. Treat the right patient in the right way. Avoid unnecessary procedures. Act before the first warning sign becomes the event everyone wishes had been prevented.
Dr. Michael Sabbah is a board-certified interventional cardiologist. He completed fellowships in cardiovascular disease, interventional cardiology and structural cardiology. He serves as the director of the cardiac catheterization lab and the structural heart program at Jupiter Medical Center. He sees Cleerly from the other side of the clinical pathway: what to do with the information once it arrives. He describes Cleerly as a key piece of the puzzle that cardiologists put together to evaluate risk and determine an individualized treatment plan. “It’s a great tool to predict whether or not additional testing may be needed,” Sabbah says.
That does not mean every patient who has a Cleerly analysis is headed towards a procedure. In some cases, the technology may help prevent one. CCTA is generally performed as an outpatient study, without sedation or anesthesia, and the visit typically takes about an hour. For patients, the most important point may be when this test enters the conversation. Cleerly is a diagnostic study, not a general screening, for asymptomatic healthy people. It is typically used for patients with symptoms such as chest pain or pressure, shortness of breath, or other symptoms that may or may not be coming from the heart.
In the past, many patients with these types of symptoms may have first underwent a traditional stress test. CCTA with Cleerly can help cardiologists decide what level of concern is appropriate and what should happen next. If someone has very typical symptoms or is considered high risk, Sabbah says cardiologists may move straight to a more invasive evaluation, which remains the gold standard to define the coronary arteries and degree of narrowing within them.
But for many patients, the scan can provide an important piece of the puzzle. CCTA is “a tool in the toolbox,” he says. “I often compare heart disease to putting together a puzzle.” Symptoms matter. So do vital signs, ultrasound findings, CT scans, lab work, family history, and the overall risk profile. No single piece tells the entire story. “But by putting all of these pieces together, we can see the picture much more ‘cleerly’,” Sabbah says.
Sometimes, the scan can be very reassuring. A patient may have symptoms, a family history, or enough risk factors to warrant concern, and the CCTA with Cleerly may show no major coronary problems. “We can all take a deep breath,” Sabbah says.
“These enhanced diagnostic tools help to avoid unnecessary procedures, as well as identify early-stage disease that can be treated with medication, changes in diet, a physician-approved exercise regimen, and monitoring,” says Sabbah. The other advantage is that CCTA can reveal any type of blockage, not just the severe ones that are causing blood flow issues. Sabbah says a nuclear stress test may show whether a blockage is 70 percent or greater, but a CT can show blockages below that level. That creates an opening for earlier action, especially in a patient with a family history or other risks. “It’s really not just about diagnosing a blockage, it’s about how we can prevent blockages from forming in the first place,” Sabbah says.
It’s clear that the future of cardiac care has arrived at JMC. CT scans and cardiac magnetic resonance imaging (MRI) will continue to progress, Sabbah says, helping doctors identify heart disease earlier and treat it more effectively. “Cardiac imaging is the future of diagnostic cardiology,” he says.
Fox sees AI expanding far beyond coronary imaging. It is already being used in breast, prostate, and pulmonary imaging. As the technology becomes more sophisticated, it will likely become part of the diagnostic routine. “AI is going to be, in the future, part of all imaging,” Fox says.