From precision to planetary health: the carbon cost of AI in multimodality cardiovascular imaging

Graphical AbstractBalancing clinical benefits and environmental cost of AI in cardiovascular imaging. Top panel. AI provides major benefits in cardiovascular imaging, including faster acquisition and reconstruction, fewer artefacts, automated segmentation and quantification, structured reporting, and clinical decision support. Middle panel. Comparison between Green AI and Red AI paradigms. While clinical performance may be similar, Green AI prioritizes efficiency and transparency, whereas Red AI is associated with disproportionate computational demand and unreported environmental costs. Bottom panel. Proposed framework for a carbon transparency statement, based on measuring energy consumption, accounting for data-centre overhead, converting energy use to carbon emissions, and reporting the full AI development footprint. AI, artificial intelligence; CVI, cardiovascular imaging; CO₂, carbon dioxide; GPU, graphics processing unit; kgCO₂e, kilograms of carbon dioxide equivalent.For image description, please refer to the figure legend and surrounding text.