Journal of Diagnostics Concepts & Practice >
Comparative study on software DEEPVESSEL FFR and invasive FFR in assessing coronary ischemia
Received date: 2021-08-13
Online published: 2022-06-28
Objective: To assess application value of artificial intelligence software DEEPVESSEL FFR(DV-FFR) in evaluating CTA (computed tomography angiography) of coronary ischemia. Methods: This was a prospective, single-center, and self-control study, and 21 vessels in 18 patients with coronary artery narrow (degree between 30%-90%) were included. Coronary ischemia was evaluated by DV-FFR and invasive FFR, and the efficiency of DV-FFR for diagnosing coronary ischemia was assessed by comparison with the results of golden criterion (invasive FFR). Based on data obtained from CTA DICOM, the blood vessel images were segmented and reconstructed by DV-FFR with deep learning technology, and vessel centerlines was obtained. FFR was calculated using3-D geometric auto-quantitative technology to assess ischemia in LAD (left anterior descending), LCX (left circumflex), RCA (right coronary artery). Results: When cut-off value of invasive FFR was taken as 0.8, DV-FFR≤0.8 was considered as functional coronary ischemia. On vessel level, the accuracy, specificity, sensitivity, positive predictive value, and negative predictive value of DV- FFR for diagnosing functional coronary ischemia were 90.5%, 88.9%, 91.7%, 91.7% and 88.9%, respectively. While on patient level, the above indexes were 88.9%, 87.5%, 90.0%, 90.0%and 87.5%, respectively. The results of the 2 methods were similar (P=0.787). Conclusions: The results of DV-FFR showed a good consistency with that of invasive FFR in evaluating coronary artery narrow degree between 30%-90%, which could be used as effective diagnostic approach.
XU Hao, ZHANG Zhi, XIE Xueqian, YANG Wenyi, LIU Shaowen . Comparative study on software DEEPVESSEL FFR and invasive FFR in assessing coronary ischemia[J]. Journal of Diagnostics Concepts & Practice, 2021 , 20(04) : 384 -390 . DOI: 10.16150/j.1671-2870.2021.04.010
[1] | Pijls NH, van Schaardenburgh P, Manoharan G, et al. Percutaneous coronary intervention of functionally nonsignificant stenosis: 5-year follow-up of the DEFER Study[J]. J Am Coll Cardiol, 2007,49(21):2105-2111. |
[2] | Tonino PA, de Bruyne B, Pijls NH, et al. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention[J]. N Engl J Med, 2009,360(3):213-224. |
[3] | de Bruyne B, Pijls NH, Kalesan B, et al. Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease[J]. N Engl J Med, 2012,367(11):991-1001. |
[4] | Koo BK, Erglis A, Doh JH, et al. Diagnosis of ischemia-causing coronary stenoses by noninvasive fractional flow reserve computed from coronary computed tomographic angiograms: results from the prospective multicenter DISCOVER-FLOW(Diagnosis of Ischemia-Causing Stenoses Obtained Via Noninvasive Fractional Flow Reserve) study[J]. J Am Coll Cardiol, 2011,58(19):1989-1997. |
[5] | Nakazato R, Park HB, Berman DS, et al. Noninvasive fractional flow reserve derived from computed tomography angiography for coronary lesions of intermediate stenosis severity results from the DeFACTO study[J]. Circ Cardiovasc Imaging, 2013,6(6):881-889. |
[6] | Gaur S, Achenbach S, Leipsic J, et al. Rationale and design of the Heart Flow NXT (HeartFlow analysis of coronary blood flow using CT angiography: NeXt sTeps) study[J]. J Cardiovasc Comput Tomogr, 2013,7(5):279-288. |
[7] | Pijls NH, Fearon WF, Tonino PA, et al. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention in patients with multivessel coronary artery disease: 2-year follow-up of the FAME (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) study[J]. J Am Coll Cardiol, 2010,56(3):177-184. |
[8] | Meijboom WB, Van Mieghem CA, van Pelt N, et al. Comprehensive assessment of coronary artery stenoses: computed tomography coronary angiography versus conventional coronary angiography and correlation with fractional flow reserve in patients with stable angina[J]. J Am Coll Cardiol, 2008,52(8): 636-643. |
[9] | Park SJ, Kang SJ, Ahn JM, et al. Visual-functional mismatch between coronary angiography and fractional flow reserve[J]. JACC Cardiovasc Interv, 2012,5(10):1029-1036. |
[10] | Kern MJ, Samady H. Current concepts of integrated coronary physiology in the catheterization laboratory[J]. J Am Coll Cardiol, 2010,55(3):173-185. |
[11] | Taylor CA, Fonte TA, Min JK, et al. Computational fluid dynamics applied to cardiac computed tomography for noninvasive quantification of fractional flow reserve:scientific basis[J]. J Am Coil Cardiol, 2013,61:2233-2241. |
[12] | Douglas PS, De Bruyne B, Pontone G, et al. 1-Year outcomes of FFRCT-guided care in patients with suspected coronary disease: the PLATFORM study[J]. J Am Coll Cardiol, 2016,68(5):435-445. |
[13] | Chinnaiyan KM, Akasaka T, Amano T, et al. Rationale,design and goals of the HeartFlow assessing diagnostic value of non-invasive FFRCT in Coronary Care (ADVANCE) registry[J]. J Cardiovasc Comput Tomogr, 2017,11(1):62-67. |
[14] | Fairbairn TA, Nieman K, Akasaka T, et al. Real-world clinical utility and impact on clinical decision-making of coronary computed tomography angiography-derived fractional flow reserve: lessons from the ADVANCE registry[J]. Eur Heart J, 2018,39(41):3701-3711. |
[15] | Pontone G, Weir-McCall JR, Baggiano A, et al. Determinants of rejection rate for coronary CT angiography fractional flow reserve analysis[J]. Radiology, 2019,292(3):597-605. |
[16] | Cavalcante R, Onuma Y, Sotomi Y, et al. Non-invasive Heart Team assessment of multivessel coronary disease with coronary computed tomography angiography based on SYNTAX score Ⅱ treatment recommendations: design and rationale of the randomised SYNTAX Ⅲ Revolution trial[J]. EuroIntervention, 2017,12(16):2001-2008. |
[17] | Sonck J, Miyazaki Y, Collet C, et al. Feasibility of planning coronary artery bypass grafting based only on coronary computed tomography angiography and CT-derived fractional flow reserve: a pilot survey of the surgeons involved in the randomized SYNTAX Ⅲ Revolution trial[J/OL]. Interact Cardiovasc Thorac Surg, 2019-05-18[2021-08-13]. https://pubmed.ncbi.nlm.nih.gov/30887024/. |
[18] | Andreini D, Modolo R, Katagiri Y, et al. Impact of fractional flow reserve derived from coronary computed tomography angiography on heart team treatment decision-making in patients with multivessel coronary artery di-sease: insights from the SYNTAX Ⅲ REVOLUTION trial[J]. Circ Cardiovasc Interv, 2019,12(12):e007607. |
/
〈 |
|
〉 |