Diagnostic accuracy of coronary computed tomography angiography-derived fractional flow reserve.
CT-derived FFR
Computational fluid dynamics
Coronary computed tomography angiography
Fractional flow reserve
Journal
Biomedical engineering online
ISSN: 1475-925X
Titre abrégé: Biomed Eng Online
Pays: England
ID NLM: 101147518
Informations de publication
Date de publication:
04 Aug 2021
04 Aug 2021
Historique:
received:
05
05
2021
accepted:
26
07
2021
entrez:
5
8
2021
pubmed:
6
8
2021
medline:
15
12
2021
Statut:
epublish
Résumé
Fractional flow reserve (FFR) is a widely used gold standard to evaluate ischemia-causing lesions. A new method of non-invasive approach, termed as AccuFFRct, for calculating FFR based on coronary computed tomography angiography (CCTA) and computational fluid dynamics (CFD) has been proposed. However, its diagnostic accuracy has not been validated. This study sought to present a novel approach for non-invasive computation of FFR and evaluate its diagnostic performance in patients with coronary stenosis. A total of 54 consecutive patients with 78 vessels from a single center who underwent CCTA and invasive FFR measurement were retrospectively analyzed. The CT-derived FFR values were computed using a novel CFD-based model (AccuFFRct, ArteryFlow Technology Co., Ltd., Hangzhou, China). Diagnostic performance of AccuFFRct and CCTA in detecting hemodynamically significant coronary artery disease (CAD) was evaluated using the invasive FFR as a reference standard. Diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for AccuFFRct in detecting FFR ≤ 0.8 on per-patient basis were 90.7, 89.5, 91.4, 85.0 and 94.1%, respectively, while those of CCTA were 38.9, 100.0, 5.71, 36.5 and 100.0%, respectively. The correlation between AccuFFRct and FFR was good (r = 0.76 and r = 0.65 on per-patient and per-vessel basis, respectively, both p < 0.0001). Area under the curve (AUC) values of AccuFFRct for identifying ischemia per-patient and per-vessel basis were 0.945 and 0.925, respectively. There was much higher accuracy, specificity and AUC for AccuFFRct compared with CCTA. AccuFFRct computed from CCTA images alone demonstrated high diagnostic performance for detecting lesion-specific ischemia, it showed superior diagnostic power than CCTA and eliminated the risk of invasive tests, which could be an accurate and time-efficient computational tool for diagnosing ischemia and assisting clinical decision-making.
Sections du résumé
BACKGROUND
BACKGROUND
Fractional flow reserve (FFR) is a widely used gold standard to evaluate ischemia-causing lesions. A new method of non-invasive approach, termed as AccuFFRct, for calculating FFR based on coronary computed tomography angiography (CCTA) and computational fluid dynamics (CFD) has been proposed. However, its diagnostic accuracy has not been validated.
OBJECTIVES
OBJECTIVE
This study sought to present a novel approach for non-invasive computation of FFR and evaluate its diagnostic performance in patients with coronary stenosis.
METHODS
METHODS
A total of 54 consecutive patients with 78 vessels from a single center who underwent CCTA and invasive FFR measurement were retrospectively analyzed. The CT-derived FFR values were computed using a novel CFD-based model (AccuFFRct, ArteryFlow Technology Co., Ltd., Hangzhou, China). Diagnostic performance of AccuFFRct and CCTA in detecting hemodynamically significant coronary artery disease (CAD) was evaluated using the invasive FFR as a reference standard.
RESULTS
RESULTS
Diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for AccuFFRct in detecting FFR ≤ 0.8 on per-patient basis were 90.7, 89.5, 91.4, 85.0 and 94.1%, respectively, while those of CCTA were 38.9, 100.0, 5.71, 36.5 and 100.0%, respectively. The correlation between AccuFFRct and FFR was good (r = 0.76 and r = 0.65 on per-patient and per-vessel basis, respectively, both p < 0.0001). Area under the curve (AUC) values of AccuFFRct for identifying ischemia per-patient and per-vessel basis were 0.945 and 0.925, respectively. There was much higher accuracy, specificity and AUC for AccuFFRct compared with CCTA.
CONCLUSIONS
CONCLUSIONS
AccuFFRct computed from CCTA images alone demonstrated high diagnostic performance for detecting lesion-specific ischemia, it showed superior diagnostic power than CCTA and eliminated the risk of invasive tests, which could be an accurate and time-efficient computational tool for diagnosing ischemia and assisting clinical decision-making.
Identifiants
pubmed: 34348731
doi: 10.1186/s12938-021-00914-3
pii: 10.1186/s12938-021-00914-3
pmc: PMC8340407
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
77Subventions
Organisme : National Natural Science Foundation of China
ID : 81320108003
Organisme : National Natural Science Foundation of China
ID : 31371498
Organisme : National Natural Science Foundation of China
ID : 81100141
Organisme : National Natural Science Foundation of China
ID : 81570322
Organisme : Zhejiang Provincial Public Welfare Technology Research Project
ID : LGF20H020012
Organisme : Zhejiang Provincial key research and development plan
ID : 2020C03016
Organisme : Major projects in Wenzhou of China
ID : ZY2019006
Organisme : Major projects in Jinhua of China
ID : 2020A31003
Organisme : Scientific research project of Zhejiang Education Department
ID : Y201330290
Informations de copyright
© 2021. The Author(s).
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