European COMBINE-CT project advances from technology development to clinical validation
Aug 28, 2026 | 2 minute read
Amsterdam, the Netherlands – Royal Philips (NYSE: PHG, AEX: PHIA), a global leader in health technology, today announced that the COMBINE-CT project, a European consortium coordinated by Philips, has advanced from technology development to clinical validation of its computed tomography (CT)-based integrated care pathway for patients with coronary artery disease (CAD).
Launched in 2023, the four-year COMBINE-CT project aims to transform coronary CT angiography (CCTA) from a diagnostic test into an AI-enabled platform for clinical decision support and treatment planning. The project is developing a connected, automated CCTA-based workflow designed to support every stage of the CAD care pathway by helping physicians select the most appropriate treatment, plan interventions, guide procedures and support follow-up care. The project brings together experts in cardiology, medical imaging, interventional procedures and AI, alongside health economists and non-profit organizations representing patients. Together, they are conducting five multicenter studies to generate evidence on the value of CCTA across the CAD care pathway. The studies will evaluate its role in definitive CAD diagnosis, treatment planning, procedure guidance and patient follow-up, while also exploring how Spectral Photon-Counting CT can be used to assess coronary artery bypass grafts and previously implanted stents. “AI-powered CT imaging is creating new opportunities for the non-invasive diagnosis and assessment of coronary artery disease while enabling more informed treatment decisions,” said Bert van Meurs, Chief Business Leader Diagnosis and Treatment, Image Guided Therapy, at Royal Philips. “By combining AI, spectral CT and minimally invasive therapies, our joint research aims to help physicians diagnose and treat coronary artery disease with greater precision, confidence and efficiency.” “Interventional cardiologists need precise and actionable information to plan and deliver the most appropriate treatment for each patient with coronary artery disease,” said Dr. Bimmer Claessen, interventional cardiologist at the Amsterdam UMC. “We are researching how combining AI, CT and interventional X-ray imaging could enhance PCI procedures to treat coronary artery disease. Through the COMBINE-CT project, we aim to make this information readily available whenever it is needed – before, during and after the procedure – helping physicians make informed decisions with greater confidence, even in highly dynamic situations.”
Innovation through public-private partnership
The IHI COMBINE-CT multistakeholder public-private partnership comprises 11 partners from six European countries. With a total project budget of EUR 10 million, the four-year project is co-funded by the industry partners through in-kind contributions and additional resources, as well as by the European Union Innovative Health Initiative (IHI).
The need for non-invasive coronary artery imaging
The most common cause of CAD is atherosclerosis – the gradual buildup of fatty deposits (plaque) within the arteries feeding the heart that restrict blood flow to the heart muscle. For patients admitted to hospital with CAD-like symptoms such as chest pain, the current gold standard for diagnosis is an invasive angiography. This involves inserting a fine tube (catheter) via the patient’s blood vessel to the heart and injecting a contrast media that shows up the coronary arteries and any obstructions in them on X-ray images. Invasive angiography needs to be performed in a cardiac catheterization laboratory (cath lab), where any discovered obstructive lesions may be treated during the same procedure. However, around 60% of patients undergoing invasive coronary angiography are found not to have significantly narrowed or blocked coronary arteries, highlighting the potential to reduce unnecessary cath lab procedures through reliable non-invasive assessment. Using innovative CT imaging technology and AI, the COMBINE-CT consortium has achieved milestone development of an end-to-end non-invasive solution for CAD diagnosis, patient stratification, treatment planning, guided intervention, and follow-up. Capable of being performed in a standard radiology department or dedicated cardiac imaging unit, the consortium has moved into its second phase of conducting clinical studies to investigate and demonstrate whether a CCTA-informed end-to-end workflow has the potential to reduce the number of invasive coronary angiographies, increase care provider efficiency, reduce costs, and offer better patient experiences and outcomes.
Coronary artery disease (often referred to as ischemic heart disease) is the leading cause of mortality worldwide [1], estimated to affect 2.5% of the world’s population and more than 5% of people in Europe in 2019 [2]. The aging population and the increasing incidence of risk factors such as obesity and Type 2 diabetes are predicted to further increase the number of CAD patients that require diagnosis and treatment [3].
Clinical studies
The following studies have been launched to investigate and demonstrate potential benefits towards supporting the adoption of CCTA-based care pathways across heart centers in Europe.
Philips and public-private partnerships for innovation
The CORDIS project page for COMBINE-CT can be accessed here. The IHI factsheet for COMBINE-CT can be found here. [1] Roth GA, Johnson C, Abajobir A, et al. Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015. J Am Coll Cardiol. 2017 Jul 4;70(1):1-25. doi: 10.1016/j.jacc.2017.04.052. Epub 2017 May 17. PMID: 28527533; PMCID: PMC5491406. [2] Virani SS, Alonso A, Aparicio HJ, et al. Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association. Circulation. 2021 Feb 23;143(8):e254-e743. doi: 10.1161/CIR.0000000000000950. Epub 2021 Jan 27. PMID: 33501848. [3] Khan MA, Hashim MJ, Mustafa H, et al. Global Epidemiology of Ischemic Heart Disease: Results from the Global Burden of Disease Study. Cureus. 2020 Jul 23;12(7):e9349. doi: 10.7759/cureus.9349. PMID: 32742886; PMCID: PMC7384703.
Public-private partnerships play a vital role in advancing healthcare innovation. With over 40 years of experience in shaping and leading such partnerships, Philips sees them as a powerful complement to its global R&D programs, helping build sustainable ecosystems that foster innovation. Philips’ broad imaging, image-guided therapy, and healthcare informatics portfolio helps clinicians visualize, assess, and guide treatment, and confirm outcomes – supporting more precise and personalized care.
More information can be viewed on the COMBINE-CT website.
This project is supported by the Innovative Health Initiative Joint Undertaking (IHI JU) under grant agreement No 101132862. The JU receives support from the European Union’s Horizon Europe research and innovation program and COCIR, EFPIA, EuropaBio, MedTech Europe and Vaccines Europe. COMBINE-CT is funded by the European Union, the private members, and those contributing partners of the IHI JU. Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the aforementioned parties. Neither of the aforementioned parties can be held responsible for them.
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