Performance of computed tomography-derived fractional flow reserve using reduced-order modelling and static computed tomography stress myocardial perfusion imaging for detection of haemodynamically significant coronary stenosis

Abdul Rahman Ihdayhid; Takuya Sakaguchi; Jesper J. Linde; Mathias H. Sørgaard; Klaus F. Kofoed; Yasuko Fujisawa; Jacqui Hislop-Jambrich; Nitesh Nerlekar; James D. Cameron; Ravi K. Munnur; Marcus Crosset; Dennis T.L. Wong; Sujith K. Seneviratne; Brian S. Ko

doi:10.1093/ehjci/jey114

Performance of computed tomography-derived fractional flow reserve using reduced-order modelling and static computed tomography stress myocardial perfusion imaging for detection of haemodynamically significant coronary stenosis

Abdul Rahman Ihdayhid, Takuya Sakaguchi, Jesper J. Linde, Mathias H. Sørgaard, Klaus F. Kofoed, Yasuko Fujisawa, Jacqui Hislop-Jambrich, Nitesh Nerlekar, James D. Cameron, Ravi K. Munnur, Marcus Crosset, Dennis T.L. Wong, Sujith K. Seneviratne, Brian S. Ko^*

^*Corresponding author for this work

Department of Clinical Medicine

12 Citations (Scopus)

Abstract

Aims To compare the diagnostic performance of a reduced-order computed tomography-derived fractional flow reserve (CT-FFR) technique derived from luminal deformation and static CT stress myocardial perfusion (CTP). Methods and results Forty-six patients (84 vessels) with suspected coronary artery disease from a single institution planned for elective coronary angiography prospectively underwent research indicated invasive fractional flow reserve (FFR) and 320-detector CT coronary angiography (CTA) and static CTP. Analyses were performed in separate blinded core laboratories for CT-FFR and CTP. CT-FFR was derived using a reduced-order model with dedicated software on a standard desktop computer. CTP was assessed visually and quantitatively by transmural perfusion ratio (TPR). Invasive FFR was significant in 33% (28/84) of vessels. Overall per-vessel sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for CT-FFR were 81%, 84%, 71%, 90%, and 83%, respectively, those of visual CTP were 54%, 92%, 79%, 77%, and 78%, respectively, and TPR were 64%, 48%, 42%, 70%, and 54%, respectively. Per-vessel receiver operator curve analysis demonstrated a significantly larger area under the curve (AUC) for CT-FFR (0.89) with that for visual CTP (0.72; P = 0.016), TPR (0.55; P < 0.0001), and CTA (0.76; P = 0.04). The addition of CT-FFR to CTA provided superior improvement in performance (AUC 0.93; P < 0.0001) compared with CTA alone, a combination of CTA with visual CTP (AUC 0.82; P = 0.007) and CTA with TPR (AUC 0.78; P = 0.0006). Conclusion Based on this selected cohort of patients, a reduced-order CT-FFR technique is superior to visual and quantitatively assessed static CTP in detecting haemodynamically significant coronary stenosis as assessed by invasive FFR. All rights reserved.

Original language	English
Journal	European Heart Journal Cardiovascular Imaging
Volume	19
Issue number	11
Pages (from-to)	1234-1243
Number of pages	10
ISSN	2047-2404
DOIs	https://doi.org/10.1093/ehjci/jey114
Publication status	Published - 2018

Keywords

computed tomography
fractional flow reserve
imaging
ischaemia
myocardial perfusion

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Ihdayhid, A. R., Sakaguchi, T., Linde, J. J., Sørgaard, M. H., Kofoed, K. F., Fujisawa, Y., Hislop-Jambrich, J., Nerlekar, N., Cameron, J. D., Munnur, R. K., Crosset, M., Wong, D. T. L., Seneviratne, S. K., & Ko, B. S. (2018). Performance of computed tomography-derived fractional flow reserve using reduced-order modelling and static computed tomography stress myocardial perfusion imaging for detection of haemodynamically significant coronary stenosis. European Heart Journal Cardiovascular Imaging, 19(11), 1234-1243. https://doi.org/10.1093/ehjci/jey114

Performance of computed tomography-derived fractional flow reserve using reduced-order modelling and static computed tomography stress myocardial perfusion imaging for detection of haemodynamically significant coronary stenosis. / Ihdayhid, Abdul Rahman; Sakaguchi, Takuya; Linde, Jesper J. et al.
In: European Heart Journal Cardiovascular Imaging, Vol. 19, No. 11, 2018, p. 1234-1243.

Research output: Contribution to journal › Journal article › Research › peer-review

Ihdayhid, AR, Sakaguchi, T, Linde, JJ, Sørgaard, MH, Kofoed, KF, Fujisawa, Y, Hislop-Jambrich, J, Nerlekar, N, Cameron, JD, Munnur, RK, Crosset, M, Wong, DTL, Seneviratne, SK & Ko, BS 2018, 'Performance of computed tomography-derived fractional flow reserve using reduced-order modelling and static computed tomography stress myocardial perfusion imaging for detection of haemodynamically significant coronary stenosis', European Heart Journal Cardiovascular Imaging, vol. 19, no. 11, pp. 1234-1243. https://doi.org/10.1093/ehjci/jey114

Ihdayhid AR, Sakaguchi T, Linde JJ, Sørgaard MH, Kofoed KF, Fujisawa Y et al. Performance of computed tomography-derived fractional flow reserve using reduced-order modelling and static computed tomography stress myocardial perfusion imaging for detection of haemodynamically significant coronary stenosis. European Heart Journal Cardiovascular Imaging. 2018;19(11):1234-1243. doi: 10.1093/ehjci/jey114

Ihdayhid, Abdul Rahman ; Sakaguchi, Takuya ; Linde, Jesper J. et al. / Performance of computed tomography-derived fractional flow reserve using reduced-order modelling and static computed tomography stress myocardial perfusion imaging for detection of haemodynamically significant coronary stenosis. In: European Heart Journal Cardiovascular Imaging. 2018 ; Vol. 19, No. 11. pp. 1234-1243.

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title = "Performance of computed tomography-derived fractional flow reserve using reduced-order modelling and static computed tomography stress myocardial perfusion imaging for detection of haemodynamically significant coronary stenosis",

abstract = "Aims To compare the diagnostic performance of a reduced-order computed tomography-derived fractional flow reserve (CT-FFR) technique derived from luminal deformation and static CT stress myocardial perfusion (CTP). Methods and results Forty-six patients (84 vessels) with suspected coronary artery disease from a single institution planned for elective coronary angiography prospectively underwent research indicated invasive fractional flow reserve (FFR) and 320-detector CT coronary angiography (CTA) and static CTP. Analyses were performed in separate blinded core laboratories for CT-FFR and CTP. CT-FFR was derived using a reduced-order model with dedicated software on a standard desktop computer. CTP was assessed visually and quantitatively by transmural perfusion ratio (TPR). Invasive FFR was significant in 33% (28/84) of vessels. Overall per-vessel sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for CT-FFR were 81%, 84%, 71%, 90%, and 83%, respectively, those of visual CTP were 54%, 92%, 79%, 77%, and 78%, respectively, and TPR were 64%, 48%, 42%, 70%, and 54%, respectively. Per-vessel receiver operator curve analysis demonstrated a significantly larger area under the curve (AUC) for CT-FFR (0.89) with that for visual CTP (0.72; P = 0.016), TPR (0.55; P < 0.0001), and CTA (0.76; P = 0.04). The addition of CT-FFR to CTA provided superior improvement in performance (AUC 0.93; P < 0.0001) compared with CTA alone, a combination of CTA with visual CTP (AUC 0.82; P = 0.007) and CTA with TPR (AUC 0.78; P = 0.0006). Conclusion Based on this selected cohort of patients, a reduced-order CT-FFR technique is superior to visual and quantitatively assessed static CTP in detecting haemodynamically significant coronary stenosis as assessed by invasive FFR. All rights reserved.",

keywords = "computed tomography, fractional flow reserve, imaging, ischaemia, myocardial perfusion",

author = "Ihdayhid, {Abdul Rahman} and Takuya Sakaguchi and Linde, {Jesper J.} and S{\o}rgaard, {Mathias H.} and Kofoed, {Klaus F.} and Yasuko Fujisawa and Jacqui Hislop-Jambrich and Nitesh Nerlekar and Cameron, {James D.} and Munnur, {Ravi K.} and Marcus Crosset and Wong, {Dennis T.L.} and Seneviratne, {Sujith K.} and Ko, {Brian S.}",

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doi = "10.1093/ehjci/jey114",

language = "English",

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pages = "1234--1243",

journal = "European Heart Journal Cardiovascular Imaging",

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T1 - Performance of computed tomography-derived fractional flow reserve using reduced-order modelling and static computed tomography stress myocardial perfusion imaging for detection of haemodynamically significant coronary stenosis

AU - Ihdayhid, Abdul Rahman

AU - Sakaguchi, Takuya

AU - Linde, Jesper J.

AU - Sørgaard, Mathias H.

AU - Kofoed, Klaus F.

AU - Fujisawa, Yasuko

AU - Hislop-Jambrich, Jacqui

AU - Nerlekar, Nitesh

AU - Cameron, James D.

AU - Munnur, Ravi K.

AU - Crosset, Marcus

AU - Wong, Dennis T.L.

AU - Seneviratne, Sujith K.

AU - Ko, Brian S.

PY - 2018

Y1 - 2018

N2 - Aims To compare the diagnostic performance of a reduced-order computed tomography-derived fractional flow reserve (CT-FFR) technique derived from luminal deformation and static CT stress myocardial perfusion (CTP). Methods and results Forty-six patients (84 vessels) with suspected coronary artery disease from a single institution planned for elective coronary angiography prospectively underwent research indicated invasive fractional flow reserve (FFR) and 320-detector CT coronary angiography (CTA) and static CTP. Analyses were performed in separate blinded core laboratories for CT-FFR and CTP. CT-FFR was derived using a reduced-order model with dedicated software on a standard desktop computer. CTP was assessed visually and quantitatively by transmural perfusion ratio (TPR). Invasive FFR was significant in 33% (28/84) of vessels. Overall per-vessel sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for CT-FFR were 81%, 84%, 71%, 90%, and 83%, respectively, those of visual CTP were 54%, 92%, 79%, 77%, and 78%, respectively, and TPR were 64%, 48%, 42%, 70%, and 54%, respectively. Per-vessel receiver operator curve analysis demonstrated a significantly larger area under the curve (AUC) for CT-FFR (0.89) with that for visual CTP (0.72; P = 0.016), TPR (0.55; P < 0.0001), and CTA (0.76; P = 0.04). The addition of CT-FFR to CTA provided superior improvement in performance (AUC 0.93; P < 0.0001) compared with CTA alone, a combination of CTA with visual CTP (AUC 0.82; P = 0.007) and CTA with TPR (AUC 0.78; P = 0.0006). Conclusion Based on this selected cohort of patients, a reduced-order CT-FFR technique is superior to visual and quantitatively assessed static CTP in detecting haemodynamically significant coronary stenosis as assessed by invasive FFR. All rights reserved.

AB - Aims To compare the diagnostic performance of a reduced-order computed tomography-derived fractional flow reserve (CT-FFR) technique derived from luminal deformation and static CT stress myocardial perfusion (CTP). Methods and results Forty-six patients (84 vessels) with suspected coronary artery disease from a single institution planned for elective coronary angiography prospectively underwent research indicated invasive fractional flow reserve (FFR) and 320-detector CT coronary angiography (CTA) and static CTP. Analyses were performed in separate blinded core laboratories for CT-FFR and CTP. CT-FFR was derived using a reduced-order model with dedicated software on a standard desktop computer. CTP was assessed visually and quantitatively by transmural perfusion ratio (TPR). Invasive FFR was significant in 33% (28/84) of vessels. Overall per-vessel sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for CT-FFR were 81%, 84%, 71%, 90%, and 83%, respectively, those of visual CTP were 54%, 92%, 79%, 77%, and 78%, respectively, and TPR were 64%, 48%, 42%, 70%, and 54%, respectively. Per-vessel receiver operator curve analysis demonstrated a significantly larger area under the curve (AUC) for CT-FFR (0.89) with that for visual CTP (0.72; P = 0.016), TPR (0.55; P < 0.0001), and CTA (0.76; P = 0.04). The addition of CT-FFR to CTA provided superior improvement in performance (AUC 0.93; P < 0.0001) compared with CTA alone, a combination of CTA with visual CTP (AUC 0.82; P = 0.007) and CTA with TPR (AUC 0.78; P = 0.0006). Conclusion Based on this selected cohort of patients, a reduced-order CT-FFR technique is superior to visual and quantitatively assessed static CTP in detecting haemodynamically significant coronary stenosis as assessed by invasive FFR. All rights reserved.

KW - computed tomography

KW - fractional flow reserve

KW - imaging

KW - ischaemia

KW - myocardial perfusion

U2 - 10.1093/ehjci/jey114

DO - 10.1093/ehjci/jey114

M3 - Journal article

C2 - 30137268

AN - SCOPUS:85055186299

SN - 2047-2404

VL - 19

SP - 1234

EP - 1243

JO - European Heart Journal Cardiovascular Imaging

JF - European Heart Journal Cardiovascular Imaging

IS - 11

ER -