Coronary CT angiography-derived fractional flow reserve correlated with invasive fractional flow reserve measurements: initial experience with a novel physician-driven algorithm

Objectives: The present study aimed to determine the feasibility of a novel fractional flow reserve (FFR) algorithm based on coronary CT angiography (cCTA) that permits point-of-care assessment, without data transfer to core laboratories, for the evaluation of potentially ischemia-causing stenoses....

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Main Author: Baumann, Stefan (Author)
Format: Article (Journal)
Language:English
Published: 18 November 2014
In: European radiology
Year: 2014, Volume: 25, Issue: 4, Pages: 1201-1207
ISSN:1432-1084
DOI:10.1007/s00330-014-3482-5
Online Access:Verlag, Volltext: http://dx.doi.org/10.1007/s00330-014-3482-5
Verlag, Volltext: https://link-springer-com.ezproxy.medma.uni-heidelberg.de/article/10.1007/s00330-014-3482-5
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Author Notes:Stefan Baumann, Rui Wang, U. Joseph Schoepf, Daniel H. Steinberg, James V. Spearman, Richard R. Bayer, Christian W. Hamm, Matthias Renker

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520 |a Objectives: The present study aimed to determine the feasibility of a novel fractional flow reserve (FFR) algorithm based on coronary CT angiography (cCTA) that permits point-of-care assessment, without data transfer to core laboratories, for the evaluation of potentially ischemia-causing stenoses. Methods: To obtain CT-based FFR, anatomical coronary information and ventricular mass extracted from cCTA datasets were integrated with haemodynamic parameters. CT-based FFR was assessed for 36 coronary artery stenoses in 28 patients in a blinded fashion and compared to catheter-based FFR. Haemodynamically relevant stenoses were defined by an invasive FFR ≤0.80. Time was measured for the processing of each cCTA dataset and CT-based FFR computation. Assessment of cCTA image quality was performed using a 5-point scale. Results: Mean total time for CT-based FFR determination was 51.9 ± 9.0 min. Per-vessel analysis for the identification of lesion-specific myocardial ischemia demonstrated good correlation (Pearson’s product-moment r = 0.74, p < 0.0001) between the prototype CT-based FFR algorithm and invasive FFR. Subjective image quality analysis resulted in a median score of 4 (interquartile ranges, 3-4). Conclusions: Our initial data suggest that the CT-based FFR method for the detection of haemodynamically significant stenoses evaluated in the selected population correlates well with invasive FFR and renders time-efficient point-of-care assessment possible. 
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