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Cardiologist in front of cardiac MRI and coronary CT angiography monitors

Cardiovascular & Thoracic Imaging

Intrinsic Imaging provides comprehensive cardiovascular imaging core lab services for pharmaceutical, biotechnology, and medical device clinical trials, combining subspecialty physician expertise, advanced quantitative imaging, and rigorous image management methodologies to support the evaluation of cardiovascular safety and efficacy. The same chest CT acquisition and quality-control discipline supports thoracic endpoints, including quantitative HRCT in interstitial lung disease and cardiopulmonary trials such as pulmonary hypertension.

Our Cardiovascular Imaging division brings together more than 150 board-certified, fellowship-trained cardiologists and cardiothoracic radiologists with expertise across a broad spectrum of cardiovascular and cardiopulmonary diseases, including heart failure, coronary artery disease, acute coronary syndromes, myocardial infarction, left ventricular dysfunction, valvular and structural heart disease, pulmonary arterial hypertension, peripheral vascular disease, and venous thromboembolic disease.

Intrinsic Imaging supports cardiovascular endpoints across an extensive range of imaging and diagnostic modalities, including 2D and 3D echocardiography, cardiac CT and CT angiography, cardiac MRI and MRA, adenosine stress MRI, invasive angiography, ECG, myocardial strain and speckle-tracking imaging, MUGA, PET, PET/CT, SPECT, nuclear cardiology, vascular ultrasound, and advanced thoracic imaging. Our teams work closely with sponsors from protocol development through database lock to establish standardized acquisition requirements, qualify and train imaging sites, define quantitative and qualitative assessment methodologies, conduct blinded independent central reviews, and implement adjudication procedures designed to minimize inter- and intra-reader variability.

By combining cardiovascular subspecialty expertise with standardized imaging protocols, centralized quality control, and reproducible quantitative assessment, Intrinsic Imaging helps sponsors generate reliable, scientifically robust imaging data suitable for longitudinal endpoint evaluation, clinical development decision-making, and global regulatory submissions.

Cardiovascular Imaging Division Highlights

  • Extensive experience in providing services in support of clinical trials evaluating cardiac safety and efficacy.
  • 150+ board-certified, fellowship-trained cardiologists and cardiothoracic radiologists.
  • Extensive experience in cardiothoracic imaging indications.
  • Focus on reducing intra-inter cardiothoracic reviewer variability.
  • Modality expertise includes:
    • 2D and 3D Echocardiography
    • Angiography, Cardiac CTA, Cardiac MRI, Chest X-Ray
    • CT, QCT, PET/CT, CR/DR, DXA
    • ECG, MRA, MRI, MRE, Adenosine Stress MRI, MUGA
    • Myocardial Strain imaging, Nuclear imaging
    • PET, SPECT, Speckle tracking, Thoracic CT/MRI, HRCT
    • Ultrasound, Vascular CTA, MRI

Cardiac Safety and Efficacy Imaging Endpoints

Our cardiac imaging core lab supports clinical trials evaluating both cardiac safety and cardiovascular efficacy. Endpoints are defined with sponsors during protocol and imaging charter development, then assessed by board-certified, fellowship-trained cardiologists and cardiothoracic radiologists using standardized quantitative and qualitative methods.

Typical assessments include left ventricular function and dysfunction, myocardial strain and speckle tracking, coronary and vascular evaluation by angiography and CTA, valvular and structural heart disease, and pulmonary and thoracic findings across heart failure, coronary artery disease, pulmonary arterial hypertension, and venous thromboembolic disease trials.

Echocardiography, Cardiac MRI and Cardiac CT Core Lab

We centrally read 2D and 3D echocardiography, cardiac MRI and MRA, adenosine stress MRI, cardiac CTA, invasive angiography, ECG, MUGA, PET, SPECT, and nuclear cardiology. Site qualification, acquisition standardization, and centralized quality control keep data consistent across sites, scanners, and longitudinal timepoints.

Blinded Independent Central Review and Adjudication

Blinded independent central review (BICR) is performed under single, double, or triple-read paradigms with adjudication procedures designed to minimize inter- and intra-reader variability, supporting reliable endpoint evaluation and global regulatory submissions.

Cardiovascular Imaging Measures and Acquisition Standards

We translate cardiac and vascular trial objectives into reproducible measurements of function, structure and treatment response. Each modality has its own acquisition instructions, measurement conventions and quality checks.

MethodMeasuresTrial applications
2D/3D echocardiographyLVEF, volumes, strain, DopplerHeart failure, cardiotoxicity, valve and structural studies
Cardiac MRIVolumes, EF, mass, LGE, T1/T2 mappingCardiomyopathy, fibrosis, inflammation, response
Cardiac/vascular CTAStenosis, plaque, vessel size, device geometryCoronary disease, vascular and structural devices
Angiography, IVUS, OCTLumen size, lesions, stent appositionCoronary interventions, device performance
PET, SPECT, MUGAPerfusion, viability, ventricular functionIschemia, myocardial viability, cardiac safety

Echocardiography and Cardiac MRI Measurement Workflows

Echo instructions define required views, frame rates, Doppler recordings and the cardiac cycles used for analysis. Readers apply consistent endocardial tracing and strain methods, with documented rules for poor acoustic windows or incomplete acquisitions.

Cardiac MRI protocols define cine coverage, temporal resolution, tissue-characterization sequences and contrast timing. Contouring conventions address papillary muscles, basal slices and ventricular boundaries to support consistent volumes and function across longitudinal visits.

Vascular and Structural Device Assessments

Central review measures anatomy, lesion severity and device-related findings using protocol-defined landmarks. Quantitative angiography and intravascular imaging support lumen and vessel analysis, while CT and echo assess structural-device positioning and functional effects. Imaging findings are kept distinct from clinical event adjudication unless both are included in the study scope.

Reproducibility Across Equipment and Readers

Site qualification addresses scanner or ultrasound platform, software version and acquisition settings. We document equipment changes, assess image suitability, calibrate readers on measurement conventions and use adjudication for endpoint-relevant disagreements. The data package includes measurement results, quality flags and traceable review records.

Guidance for Sponsors

Physician-authored guidance from Intrinsic Imaging on imaging endpoints and trial design.

Illustration of the heart and coronary vessels

Guidance for Sponsors · Volume 4, Issue 10 · 2026 Edition

Echocardiography: Advantages in Clinical Trials

Echocardiography is safe, portable, affordable and available worldwide, which makes it one of the most practical imaging tools for clinical trials. It measures chamber size, function, valves and mass, and changes in these measures predict major cardiovascular events, allowing smaller trials and earlier answers. Since the first edition of this issue, global longitudinal strain and three-dimensional echocardiography have become standard measures, and cardio-oncology guidelines now define cardiac injury from cancer therapy partly by strain. Standardized acquisition and core-lab reading remain essential.

Read the article
Illustration of the heart and blue blood vessels

Guidance for Sponsors · Volume 5, Issue 6 · 2026 Edition

Contrast Echocardiographic Imaging in Clinical Trials

Ultrasound enhancing agents turn a difficult echocardiogram into a diagnostic one. By opacifying the left ventricle and sharpening the endocardial border, they improve the accuracy and reproducibility of ejection fraction and wall motion analysis, measures that sit at the heart of many cardiovascular and cardio-oncology trials. Over the past two decades, regulators have progressively relaxed the restrictions placed on these agents as their safety record has grown. This issue reviews the technology, its regulatory history and the role of myocardial perfusion, and sets out what sponsors should specify when contrast echocardiography supports a trial endpoint.

Read the article
Illustration of the heart and coronary arteries

Guidance for Sponsors · Volume 5, Issue 7 · 2026 Edition

Coronary Artery Calcium Scoring in Clinical Trials

Coronary artery calcium scoring is one of the most powerful and economical predictors of cardiovascular risk, and an established biomarker in trials of preventive therapy. Yet the score is less simple than it appears. Calcium density carries prognostic information of its own, scores vary between scanners, vendors and software, and photon-counting CT is now changing the measurement itself. This issue reviews the method, the CAC-DRS reporting system and the sources of variability that sponsors must control when calcium scoring supports a trial endpoint.

Read the article

More guidance: IVC Filter Imaging in Clinical Trials

Browse all Guidance for Sponsors →

Featured Case Study

Intrinsic Imaging

Cardiovascular & Thoracic

Global Cardiovascular Trial With CCTA and MRI

  • 60 sites
  • CCTA, cardiac MRI
  • Plaque, stenosis and LVEF

Challenge

This global cardiovascular outcomes trial required reproducible quantification of coronary plaque burden, stenosis grading, and left ventricular ejection fraction across 60 sites operating a heterogeneous mix of scanner models. Each measurement contributed to endpoint assessment, and even modest inter-reader or inter-site variability could obscure a potential treatment effect. The sponsor required acquisition and interpretation methods that supported measurement comparability across sites and scanner platforms, with technical limitations identified and documented throughout the program.

Read the case study
View all case studies

More Cardiovascular & Thoracic case studies

Frequently Asked Questions

Which cardiac imaging modalities does the core lab read?
Our readers interpret echocardiography (2D/3D), cardiac MRI and MRA, stress MRI, cardiac and vascular CTA, angiography, ECG, MUGA, PET, SPECT, nuclear cardiology, ultrasound and thoracic CT/MRI/HRCT.
Does Intrinsic Imaging support cardiac safety as well as efficacy endpoints?
Yes. The Cardiovascular Imaging division supports clinical trials evaluating both cardiac safety and cardiovascular efficacy.
Who performs cardiovascular reads?
Reads are performed by more than 150 board-certified, fellowship-trained cardiologists and cardiothoracic radiologists.

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