PRIME 2.0: Proposed Requirements for Cardiovascular Imaging-Related Multimodal-AI Evaluation

Kagiyama, Nobuyuki and Tokodi, Márton and Hathaway, Quincy A. and Arnaout, Rima and Davies, Rhodri and Dey, Damini and Duchateau, Nicolas and Fraser, Alan G. and Goto, Shinichi and Jamthikar, Ankush D. and Lam, Carolyn S. P. and Oikonomou, Evangelos K. and Ouyang, David and Pandey, Ambarish and Poterucha, Timothy J. and Raisi-Estabragh, Zahra and Strom, Jordan B. and Zhang, Qiang and Yanamala, Naveena and Sengupta, Partho P. (2026) PRIME 2.0: Proposed Requirements for Cardiovascular Imaging-Related Multimodal-AI Evaluation. JACC-CARDIOVASCULAR IMAGING, 19 (2). pp. 225-251. ISSN 1936-878X

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Abstract

The PRIME (Proposed Requirements for Cardiovascular Imaging–Related Machine Learning Evaluation) 2.0 checklist is an updated, domain-specific framework designed to standardize the development, evaluation, and reporting of artificial intelligence (AI) applications in cardiovascular imaging. This update specifically responds to rapid advances from traditional machine learning to deep learning, large language models, and multimodal generative AI. The updated checklist was developed through a modified Delphi process by an international panel of clinical and technical experts. In contrast to general AI reporting guidelines, it delivers detailed, practical recommendations on all critical aspects of AI research and builds upon the original 7-domain framework by incorporating cardiovascularimaging–specific complexities such as cardiac motion, imaging artifacts, and interobserver variability. By promoting transparency and rigor, PRIME 2.0can serve as a vital resource for researchers, clinicians, peer reviewers, and journal editors working at the forefront of AI in cardiovascular imaging.

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