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Diagnostic Accuracy of a Novel On-site Virtual Fractional Flow Reserve Parallel Computing System

 Hyung-Bok Park  ;  Yeonggul Jang  ;  Reza Arsanjani  ;  Minh Tuan Nguyen  ;  Sang-Eun Lee  ;  Byunghwan Jeon  ;  Sunghee Jung  ;  Youngtaek Hong  ;  Seongmin Ha  ;  Sekeun Kim  ;  Sang-Wook Lee  ;  Hyuk-Jae Chang 
 YONSEI MEDICAL JOURNAL, Vol.61(2) : 137-144, 2020 
Journal Title
Issue Date
Fractional flow reserve, myocardial ; computed tomography angiography ; patient-specific computational modeling
PURPOSE: To evaluate the diagnostic accuracy of a novel on-site virtual fractional flow reserve (vFFR) derived from coronary computed tomography angiography (CTA). MATERIALS AND METHODS: We analyzed 100 vessels from 57 patients who had undergone CTA followed by invasive FFR during coronary angiography. Coronary lumen segmentation and three-dimensional reconstruction were conducted using a completely automated algorithm, and parallel computing based vFFR prediction was performed. Lesion-specific ischemia based on FFR was defined as significant at ≤0.8, as well as ≤0.75, and obstructive CTA stenosis was defined that ≥50%. The diagnostic performance of vFFR was compared to invasive FFR at both ≤0.8 and ≤0.75. RESULTS: The average computation time was 12 minutes per patient. The correlation coefficient (r) between vFFR and invasive FFR was 0.75 [95% confidence interval (CI) 0.65 to 0.83], and Bland-Altman analysis showed a mean bias of 0.005 (95% CI -0.011 to 0.021) with 95% limits of agreement of -0.16 to 0.17 between vFFR and FFR. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were 78.0%, 87.1%, 72.5%, 58.7%, and 92.6%, respectively, using the FFR cutoff of 0.80. They were 87.0%, 95.0%, 80.0%, 54.3%, and 98.5%, respectively, with the FFR cutoff of 0.75. The area under the receiver-operating characteristics curve of vFFR versus obstructive CTA stenosis was 0.88 versus 0.61 for the FFR cutoff of 0.80, respectively; it was 0.94 versus 0.62 for the FFR cutoff of 0.75. CONCLUSION: Our novel, fully automated, on-site vFFR technology showed excellent diagnostic performance for the detection of lesion-specific ischemia.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > BioMedical Science Institute (의생명과학부) > 1. Journal Papers
Yonsei Authors
Park, Hyung Bok(박형복)
Lee, Sang Eun(이상은) ORCID logo https://orcid.org/0000-0001-6645-4038
Jang, Yeong Gul(장영걸)
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
Jeon, Byung Hwan(전병환)
Hong, Youngtaek(홍영택)
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