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Application of speCtraL computed tomogrAphy to impRove specIficity of cardiac compuTed tomographY (CLARITY study): rationale and design
INTRODUCTION: Anatomic stenosis evaluation on coronary CT angiography (CCTA) lacks specificity in indicating the functional significance of a stenosis. Recent developments in CT techniques (including dual-layer spectral detector CT [SDCT] and static stress CT perfusion [CTP]) and image analyses (inc...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6429912/ https://www.ncbi.nlm.nih.gov/pubmed/30826767 http://dx.doi.org/10.1136/bmjopen-2018-025793 |
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author | van Hamersvelt, Robbert Willem Išgum, Ivana de Jong, Pim A Cramer, Maarten Jan Maria Leenders, Geert E H Willemink, Martin J Voskuil, Michiel Leiner, Tim |
author_facet | van Hamersvelt, Robbert Willem Išgum, Ivana de Jong, Pim A Cramer, Maarten Jan Maria Leenders, Geert E H Willemink, Martin J Voskuil, Michiel Leiner, Tim |
author_sort | van Hamersvelt, Robbert Willem |
collection | PubMed |
description | INTRODUCTION: Anatomic stenosis evaluation on coronary CT angiography (CCTA) lacks specificity in indicating the functional significance of a stenosis. Recent developments in CT techniques (including dual-layer spectral detector CT [SDCT] and static stress CT perfusion [CTP]) and image analyses (including fractional flow reserve [FFR] derived from CCTA images [FFR(CT)] and deep learning analysis [DL]) are potential strategies to increase the specificity of CCTA by combining both anatomical and functional information in one investigation. The aim of the current study is to assess the diagnostic performance of (combinations of) SDCT, CTP, FFR(CT) and DL for the identification of functionally significant coronary artery stenosis. METHODS AND ANALYSIS: Seventy-five patients aged 18 years and older with stable angina and known coronary artery disease and scheduled to undergo clinically indicated invasive FFR will be enrolled. All subjects will undergo the following SDCT scans: coronary calcium scoring, static stress CTP, rest CCTA and if indicated (history of myocardial infarction) a delayed enhancement acquisition. Invasive FFR of ≤0.80, measured within 30 days after the SDCT scans, will be used as reference to indicate a functionally significant stenosis. The primary study endpoint is the diagnostic performance of SDCT (including CTP) for the identification of functionally significant coronary artery stenosis. Secondary study endpoint is the diagnostic performance of SDCT, CTP, FFR(CT) and DL separately and combined for the identification of functionally significant coronary artery stenosis. ETHICS AND DISSEMINATION: Ethical approval was obtained. All subjects will provide written informed consent. Study findings will be disseminated through peer-reviewed conference presentations and journal publications. TRIAL REGISTRATION NUMBER: NCT03139006; Pre-results. |
format | Online Article Text |
id | pubmed-6429912 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-64299122019-04-05 Application of speCtraL computed tomogrAphy to impRove specIficity of cardiac compuTed tomographY (CLARITY study): rationale and design van Hamersvelt, Robbert Willem Išgum, Ivana de Jong, Pim A Cramer, Maarten Jan Maria Leenders, Geert E H Willemink, Martin J Voskuil, Michiel Leiner, Tim BMJ Open Radiology and Imaging INTRODUCTION: Anatomic stenosis evaluation on coronary CT angiography (CCTA) lacks specificity in indicating the functional significance of a stenosis. Recent developments in CT techniques (including dual-layer spectral detector CT [SDCT] and static stress CT perfusion [CTP]) and image analyses (including fractional flow reserve [FFR] derived from CCTA images [FFR(CT)] and deep learning analysis [DL]) are potential strategies to increase the specificity of CCTA by combining both anatomical and functional information in one investigation. The aim of the current study is to assess the diagnostic performance of (combinations of) SDCT, CTP, FFR(CT) and DL for the identification of functionally significant coronary artery stenosis. METHODS AND ANALYSIS: Seventy-five patients aged 18 years and older with stable angina and known coronary artery disease and scheduled to undergo clinically indicated invasive FFR will be enrolled. All subjects will undergo the following SDCT scans: coronary calcium scoring, static stress CTP, rest CCTA and if indicated (history of myocardial infarction) a delayed enhancement acquisition. Invasive FFR of ≤0.80, measured within 30 days after the SDCT scans, will be used as reference to indicate a functionally significant stenosis. The primary study endpoint is the diagnostic performance of SDCT (including CTP) for the identification of functionally significant coronary artery stenosis. Secondary study endpoint is the diagnostic performance of SDCT, CTP, FFR(CT) and DL separately and combined for the identification of functionally significant coronary artery stenosis. ETHICS AND DISSEMINATION: Ethical approval was obtained. All subjects will provide written informed consent. Study findings will be disseminated through peer-reviewed conference presentations and journal publications. TRIAL REGISTRATION NUMBER: NCT03139006; Pre-results. BMJ Publishing Group 2019-03-01 /pmc/articles/PMC6429912/ /pubmed/30826767 http://dx.doi.org/10.1136/bmjopen-2018-025793 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Radiology and Imaging van Hamersvelt, Robbert Willem Išgum, Ivana de Jong, Pim A Cramer, Maarten Jan Maria Leenders, Geert E H Willemink, Martin J Voskuil, Michiel Leiner, Tim Application of speCtraL computed tomogrAphy to impRove specIficity of cardiac compuTed tomographY (CLARITY study): rationale and design |
title | Application of speCtraL computed tomogrAphy to impRove specIficity of cardiac compuTed tomographY (CLARITY study): rationale and design |
title_full | Application of speCtraL computed tomogrAphy to impRove specIficity of cardiac compuTed tomographY (CLARITY study): rationale and design |
title_fullStr | Application of speCtraL computed tomogrAphy to impRove specIficity of cardiac compuTed tomographY (CLARITY study): rationale and design |
title_full_unstemmed | Application of speCtraL computed tomogrAphy to impRove specIficity of cardiac compuTed tomographY (CLARITY study): rationale and design |
title_short | Application of speCtraL computed tomogrAphy to impRove specIficity of cardiac compuTed tomographY (CLARITY study): rationale and design |
title_sort | application of spectral computed tomography to improve specificity of cardiac computed tomography (clarity study): rationale and design |
topic | Radiology and Imaging |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6429912/ https://www.ncbi.nlm.nih.gov/pubmed/30826767 http://dx.doi.org/10.1136/bmjopen-2018-025793 |
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