Brian S Ko1, Dennis T L Wong1, Bjarne L Nørgaard1, Darryl P Leong1, James D Cameron1, Sara Gaur1, Mohamed Marwan1, Stephan Achenbach1, Sachio Kuribayashi1, Takeshi Kimura1, Ian T Meredith1, Sujith K Seneviratne1. 1. From the Monash Cardiovascular Research Centre, Department of Medicine (Monash Medical Centre) Monash University and Monash Heart, Monash Health, 246 Clayton Rd, Clayton, 3168 VIC, Australia (B.S.K., D.T.L.W., J.D.C., I.T.M., S.K.S.); Discipline of Medicine, University of Adelaide, Adelaide, Australia (D.T.L.W., D.P.L.); Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark (B.L.N., S.G.); Department of Cardiology, Erlangen University Hospital, Erlangen, Germany (M.M., S.A.); Department of Diagnostic Radiology, Keio University, Tokyo, Japan (S.K.); and Department of Cardiovascular Medicine, Kyoto University, Kyoto, Japan (T.K.).
Abstract
PURPOSE: To compare the diagnostic performance of 320-detector row computed tomography (CT) coronary angiography-derived computed fractional flow reserve (FFR; FFRCT), transluminal attenuation gradient (TAG; TAG320), and CT coronary angiography alone to diagnose hemodynamically significant stenosis as determined by invasive FFR. MATERIALS AND METHODS: This substudy of the prospective NXT study (no. NCT01757678) was approved by each participating institution's review board, and informed consent was obtained from all participants. Fifty-one consecutive patients who underwent 320-detector row CT coronary angiographic examination and invasive coronary angiography with FFR measurement were included. Independent core laboratories determined coronary artery disease severity by using CT coronary angiography, TAG320, FFRCT, and FFR. TAG320 is defined as the linear regression coefficient between luminal attenuation and axial distance from the coronary ostium. FFRCT was computed from CT coronary angiography data by using computational fluid dynamics technology. Diagnostic performance was evaluated and compared on a per-vessel basis by the area under the receiver operating characteristic (ROC) curve (AUC). RESULTS: Among 82 vessels, 24 lesions (29%) had ischemia by FFR (FFR ≤ 0.80). FFRCT exhibited a stronger correlation with invasive FFR compared with TAG320 (Spearman ρ, 0.78 vs 0.47, respectively). Overall per-vessel accuracy, sensitivity, specificity, and positive and negative predictive values for TAG320 (<15.37) were 78%, 58%, 86%, 64%, and 83%, respectively; and those of FFRCT were 83%, 92%, 79%, 65%, and 96%, respectively. ROC curve analysis showed a significantly larger AUC for FFRCT (0.93) compared with that for TAG320 (0.72; P = .003) and CT coronary angiography alone (0.68; P = .008). CONCLUSION: FFRCT computed from 320-detector row CT coronary angiography provides better diagnostic performance for the diagnosis of hemodynamically significant coronary stenoses compared with CT coronary angiography and TAG320.
PURPOSE: To compare the diagnostic performance of 320-detector row computed tomography (CT) coronary angiography-derived computed fractional flow reserve (FFR; FFRCT), transluminal attenuation gradient (TAG; TAG320), and CT coronary angiography alone to diagnose hemodynamically significant stenosis as determined by invasive FFR. MATERIALS AND METHODS: This substudy of the prospective NXT study (no. NCT01757678) was approved by each participating institution's review board, and informed consent was obtained from all participants. Fifty-one consecutive patients who underwent 320-detector row CT coronary angiographic examination and invasive coronary angiography with FFR measurement were included. Independent core laboratories determined coronary artery disease severity by using CT coronary angiography, TAG320, FFRCT, and FFR. TAG320 is defined as the linear regression coefficient between luminal attenuation and axial distance from the coronary ostium. FFRCT was computed from CT coronary angiography data by using computational fluid dynamics technology. Diagnostic performance was evaluated and compared on a per-vessel basis by the area under the receiver operating characteristic (ROC) curve (AUC). RESULTS: Among 82 vessels, 24 lesions (29%) had ischemia by FFR (FFR ≤ 0.80). FFRCT exhibited a stronger correlation with invasive FFR compared with TAG320 (Spearman ρ, 0.78 vs 0.47, respectively). Overall per-vessel accuracy, sensitivity, specificity, and positive and negative predictive values for TAG320 (<15.37) were 78%, 58%, 86%, 64%, and 83%, respectively; and those of FFRCT were 83%, 92%, 79%, 65%, and 96%, respectively. ROC curve analysis showed a significantly larger AUC for FFRCT (0.93) compared with that for TAG320 (0.72; P = .003) and CT coronary angiography alone (0.68; P = .008). CONCLUSION: FFRCT computed from 320-detector row CT coronary angiography provides better diagnostic performance for the diagnosis of hemodynamically significant coronary stenoses compared with CT coronary angiography and TAG320.
Authors: Matthias Rief; Marcus Y Chen; Andrea L Vavere; Benjamin Kendziora; Julie M Miller; W Patricia Bandettini; Christopher Cox; Richard T George; João Lima; Marcelo Di Carli; Michail Plotkin; Elke Zimmermann; Michael Laule; Peter Schlattmann; Andrew E Arai; Marc Dewey Journal: Radiology Date: 2017-09-25 Impact factor: 11.105
Authors: Francesco Secchi; Marco Alì; Elena Faggiano; Paola Maria Cannaò; Marco Fedele; Silvia Tresoldi; Giovanni Di Leo; Ferdinando Auricchio; Francesco Sardanelli Journal: Eur Heart J Suppl Date: 2016-04-29 Impact factor: 1.803