A Novel CT Perfusion-Based Fractional Flow Reserve Algorithm for Detecting Coronary Artery Disease
dc.contributor.author | Gao, X. | |
dc.contributor.author | Wang, R. | |
dc.contributor.author | Sun, Zhonghua | |
dc.contributor.author | Zhang, H. | |
dc.contributor.author | Bo, K. | |
dc.contributor.author | Xue, X. | |
dc.contributor.author | Yang, J. | |
dc.contributor.author | Xu, L. | |
dc.date.accessioned | 2023-03-10T06:39:40Z | |
dc.date.available | 2023-03-10T06:39:40Z | |
dc.date.issued | 2023 | |
dc.identifier.citation | Gao, X. and Wang, R. and Sun, Z. and Zhang, H. and Bo, K. and Xue, X. and Yang, J. et al. 2023. A Novel CT Perfusion-Based Fractional Flow Reserve Algorithm for Detecting Coronary Artery Disease. Journal of Clinical Medicine. 12 (6): 2154. | |
dc.identifier.uri | http://hdl.handle.net/20.500.11937/90831 | |
dc.identifier.doi | 10.3390/jcm12062154 | |
dc.description.abstract |
Background: The diagnostic accuracy of fractional flow reserve (FFR) derived from coronary computed tomography angiography (CCTA) (FFR-CT) needs to be further improved despite promising results available in the literature. While an innovative myocardial computed tomographic perfusion (CTP)-derived fractional flow reserve (CTP-FFR) model has been initially established, the feasibility of CTP-FFR to detect coronary artery ischemia in patients with suspected coronary artery disease (CAD) has not been proven. Methods: This retrospective study included 93 patients (a total of 103 vessels) who received CCTA and CTP for suspected CAD. Invasive coronary angiography (ICA) was performed within 2 weeks after CCTA and CTP. CTP-FFR, CCTA (stenosis ≥ 50% and ≥70%), ICA, FFR-CT and CTP were assessed by independent laboratory experts. The diagnostic ability of the CTP-FFR grouped by quantitative coronary angiography (QCA) in mild (30–49%), moderate (50–69%) and severe stenosis (≥70%) was calculated. The effect of calcification of lesions, grouped by FFR on CTP-FFR measurements, was also assessed. Results: On the basis of per-vessel level, the AUCs for CTP-FFR, CTP, FFR-CT and CCTA were 0.953, 0.876, 0.873 and 0.830, respectively (all p < 0.001). The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of CTP-FFR for per-vessel level were 0.87, 0.88, 0.87, 0.85 and 0.89 respectively, compared with 0.87, 0.54, 0.69, 0.61, 0.83 and 0.75, 0.73, 0.74, 0.70, 0.77 for CCTA ≥ 50% and ≥70% stenosis, respectively. On the basis of per-vessel analysis, CTP-FFR had higher specificity, accuracy and AUC compared with CCTA and also higher AUC compared with FFR-CT or CTP (all p < 0.05). The sensitivity and accuracy of CTP-FFR + CTP + FFR-CT were also improved over FFR-CT alone (both p < 0.05). It also had improved specificity compared with FFR-CT or CTP alone (p < 0.01). A strong correlation between CTP-FFR and invasive FFR values was found on per-vessel analysis (Pearson’s correlation coefficient 0.89). The specificity of CTP-FFR was higher in the severe calcification group than in the low calcification group (p < 0.001). Conclusions: A novel CTP-FFR model has promising value to detect myocardial ischemia in CAD, particularly in mild-to-moderate stenotic lesions. | |
dc.publisher | MDPI AG | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
dc.subject | 1102 - Cardiorespiratory Medicine And Haematology | |
dc.subject | 3201 - Cardiovascular medicine and haematology | |
dc.title | A Novel CT Perfusion-Based Fractional Flow Reserve Algorithm for Detecting Coronary Artery Disease | |
dc.type | Journal Article | |
dcterms.source.volume | 12 | |
dcterms.source.number | 6 | |
dcterms.source.startPage | 1 | |
dcterms.source.endPage | 15 | |
dcterms.source.issn | 2077-0383 | |
dcterms.source.title | Journal of Clinical Medicine | |
dc.date.updated | 2023-03-10T06:39:39Z | |
curtin.department | Curtin Medical School | |
curtin.accessStatus | Open access | |
curtin.faculty | Faculty of Health Sciences | |
curtin.contributor.orcid | Sun, Zhonghua [0000-0002-7538-4761] | |
curtin.contributor.researcherid | Sun, Zhonghua [B-3125-2010] | |
curtin.identifier.article-number | 2154 | |
curtin.contributor.scopusauthorid | Sun, Zhonghua [12544503300] |