Comparison of invasively measured FFR with FFR derived from coronary CT angiography for detection of lesion-specific ischemia: Results from a PC-based prototype algorithm

Röther J, Moshage M, Dey D, Schwemmer C, Tröbs M, Blachutzik F, Achenbach S, Schlundt C, Marwan M (2018)

Publication Type: Journal article

Publication year: 2018

Journal

Journal of Cardiovascular Computed Tomography Elsevier

Book Volume: 12

Pages Range: 101-107

Journal Issue: 2

DOI: 10.1016/j.jcct.2018.01.012

Abstract

BACKGROUND: We evaluated the diagnostic accuracy of a novel prototype for on-site determination of CT-based FFR (cFFR) on a standard personal computer (PC) compared to invasively measured FFR in patients with suspected coronary artery disease. METHODS: A total of 91 vessels in 71 patients (mean age 65 ± 9 years) in whom coronary CT angiography had been performed due to suspicion of coronary artery disease, and who subsequently underwent invasive coronary angiography with FFR measurement were analyzed. For both cFFR and FFR, a threshold of ≤0.80 was used to indicate a hemodynamically relevant stenosis. The mean time needed to calculate cFFR was 12.4 ± 3.4 min. A very close correlation between cFFR and FFR could be shown (r = 0.85; p < 0.0001) with Bland-Altman analysis showing moderate agreement between FFR and cFFR with mild systematic overestimation of FFR values in CT (mean difference 0.0049, 95% limits of agreement ±2SD -0.007 to 0.008). Compared to FFR, the sensitivity of cFFR to detect hemodynamically significant lesions was 91% (19/21, 95% CI: 70%-99%), specificity was 96% (67/70, 95% CI: 88%-99%), positive predictive value 86% (95% CI: 65%-97%) and negative predictive value was 97% (95% CI: 90%-100%) with an accuracy of 93%. CONCLUSION: cFFR obtained using an on-site algorithm implemented on a standard PC shows high diagnostic accuracy to detect lesions causing ischemia as compared to FFR. Importantly, the time needed for analysis is short which may be useful for improving clinical workflow.

Authors with CRIS profile

Jens Röther Department of Medicine 2 – Cardiology and Angiology Monique Tröbs Department of Medicine 2 – Cardiology and Angiology Stephan Achenbach Department of Medicine 2 – Cardiology and Angiology Christian Schlundt Department of Medicine 2 – Cardiology and Angiology Mohamed Marwan Department of Medicine 2 – Cardiology and Angiology

Involved external institutions

Siemens AG, Healthcare Sector DE Germany (DE) Cedars-Sinai Medical Center US United States (USA) (US)

How to cite

APA:

Röther, J., Moshage, M., Dey, D., Schwemmer, C., Tröbs, M., Blachutzik, F.,... Marwan, M. (2018). Comparison of invasively measured FFR with FFR derived from coronary CT angiography for detection of lesion-specific ischemia: Results from a PC-based prototype algorithm. Journal of Cardiovascular Computed Tomography, 12(2), 101-107. https://dx.doi.org/10.1016/j.jcct.2018.01.012

MLA:

Röther, Jens, et al. "Comparison of invasively measured FFR with FFR derived from coronary CT angiography for detection of lesion-specific ischemia: Results from a PC-based prototype algorithm." Journal of Cardiovascular Computed Tomography 12.2 (2018): 101-107.

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