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Diagnostic Performance of a Novel Method for Fractional Flow Reserve Computed from Noninvasive Computed Tomography Angiography (NOVEL-FLOW Study)

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Author(s)
Ju-Hyun ChungKyung Eun LeeChang-Wook NamJoon-Hyung DohHyung Il KimSoon-Sung KwonEun Bo ShimEun-Seok Shin
Keimyung Author(s)
Nam, Chang Wook
Department
Dept. of Internal Medicine (내과학)
Journal Title
American Journal of Cardiology
Issued Date
2017
Volume
120
Issue
3
Abstract
Coronary computed tomography angiography (CCTA)-derived fractional flow reserve from computed tomography (CT-FFR) may provide better diagnostic performance over CCTA alone, but the complexity of its method limits the use in clinical environment. The aim of the present study is to validate a newly developed vessel-length based computational fluid dynamics scheme for the computation of FFR based on CCTA data, compare them with invasively measured FFR, and evaluate its diagnostic performance with that of CCTA. One hundred seventeen patients from 4 medical institutions who had clinically indicated invasive coronary angiography for suspected coronary artery disease (CAD) were enrolled. Invasive FFR measurement was performed in 218 vessels and these measurements were regarded as the reference standard. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of CT-FFR on a per-vessel basis were 85.8%, 86.2%, 85.5%, 79.8%, and 90.3%, respectively, for CT-FFR ≤0.80, and 66.1%, 75.9%, 59.5%, 55.5%, and 78.8%, respectively, for CCTA ≥50%. A higher area under the receiver operating characteristic curve for CT-FFR was observed compared with CCTA (0.93 vs 0.74, p <0.0001). The CT-FFR and FFR correlated well (r = 0.76, p <0.001) with slight underestimation by CT-FFR (0.014 ± 0.077, p = 0.007). With a novel method of vessel-length based computational fluid dynamics scheme, CT-FFR can be performed at a personal computer enhancing its applicability in clinical situation. The diagnostic accuracy of CT-FFR for the detection of functionally significant CAD was good and was superior to that of CCTA within a population of suspected CAD.
Keimyung Author(s)(Kor)
남창욱
Publisher
School of Medicine (의과대학)
Citation
Ju-Hyun Chung et al. (2017). Diagnostic Performance of a Novel Method for Fractional Flow Reserve Computed from Noninvasive Computed Tomography Angiography (NOVEL-FLOW Study). American Journal of Cardiology, 120(3), 362–368. doi: 10.1016/j.amjcard.2017.04.057
Type
Article
ISSN
0002-9149
Source
https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(17)30796-8
DOI
10.1016/j.amjcard.2017.04.057
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41185
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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