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Functional Evaluation of Intermediate Coronary Lesions with Integrated Computed Tomography Angiography and Invasive Angiography in Patients with Stable Coronary Artery Disease
BACKGROUND AND OBJECTIVES: The hemodynamic evaluation of coronary stenoses undergoes a transition from wire-based invasive measurements to image-based computational assessments. However, fractional flow reserve (FFR) values derived from coronary CT angiography (CCTA) and angiography-based quantitati...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sciendo
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9901557/ https://www.ncbi.nlm.nih.gov/pubmed/36776233 http://dx.doi.org/10.2478/jtim-2022-0018 |
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author | Xue, Jingyi Li, Jianqiang Sun, Danghui Sheng, Li Gong, Yongtai Wang, Dingyu Zhang, Song Zou, Yilun Shi, Jing Xu, Wei An, Mengnan Dai, Chenguang Li, Weimin Zheng, Linqun Vinograd, Asiia Liu, Guangzhong Kong, Yihui Li, Yue |
author_facet | Xue, Jingyi Li, Jianqiang Sun, Danghui Sheng, Li Gong, Yongtai Wang, Dingyu Zhang, Song Zou, Yilun Shi, Jing Xu, Wei An, Mengnan Dai, Chenguang Li, Weimin Zheng, Linqun Vinograd, Asiia Liu, Guangzhong Kong, Yihui Li, Yue |
author_sort | Xue, Jingyi |
collection | PubMed |
description | BACKGROUND AND OBJECTIVES: The hemodynamic evaluation of coronary stenoses undergoes a transition from wire-based invasive measurements to image-based computational assessments. However, fractional flow reserve (FFR) values derived from coronary CT angiography (CCTA) and angiography-based quantitative flow ratio have certain limitations in accuracy and efficiency, preventing their widespread use in routine practice. Hence, we aimed to investigate the diagnostic performance of FFR derived from the integration of CCTA and invasive angiography (FFR(CT-angio)) with artificial intelligence assistance in patients with stable coronary artery disease (CAD). METHODS: Forty stable CAD patients with 67 target vessels (50%–90% diameter stenosis) were included in this single-center retrospective study. All patients underwent CCTA followed by coronary angiography with FFR measurement within 30 days. Both CCTA and angiographic images were combined to generate a three-dimensional reconstruction of the coronary arteries using artificial intelligence. Subsequently, functional assessment was performed through a deep learning algorithm. FFR was used as the reference. RESULTS: FFR(CT-angio) values were significantly correlated with FFR values (r = 0.81, P < 0.001, Spearman analysis). Per-vessel diagnostic accuracy of FFR(CT-angio) was 92.54%. Sensitivity and specificity in identifying ischemic lesions were 100% and 88.10%, respectively. Positive predictive value and negative predictive value were 83.33% and 100%, respectively. Moreover, the diagnostic performance of FFR(CT-angio) was satisfactory in different target vessels and different segment lesions. CONCLUSIONS: FFR(CT-angio) exhibits excellent diagnostic performance of identifying ischemic lesions in patients with stable CAD. Combining CCTA and angiographic imaging, FFR(CT-angio) may represent an effective and practical alternative to invasive FFR in selected patients. |
format | Online Article Text |
id | pubmed-9901557 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Sciendo |
record_format | MEDLINE/PubMed |
spelling | pubmed-99015572023-02-09 Functional Evaluation of Intermediate Coronary Lesions with Integrated Computed Tomography Angiography and Invasive Angiography in Patients with Stable Coronary Artery Disease Xue, Jingyi Li, Jianqiang Sun, Danghui Sheng, Li Gong, Yongtai Wang, Dingyu Zhang, Song Zou, Yilun Shi, Jing Xu, Wei An, Mengnan Dai, Chenguang Li, Weimin Zheng, Linqun Vinograd, Asiia Liu, Guangzhong Kong, Yihui Li, Yue J Transl Int Med Original Article BACKGROUND AND OBJECTIVES: The hemodynamic evaluation of coronary stenoses undergoes a transition from wire-based invasive measurements to image-based computational assessments. However, fractional flow reserve (FFR) values derived from coronary CT angiography (CCTA) and angiography-based quantitative flow ratio have certain limitations in accuracy and efficiency, preventing their widespread use in routine practice. Hence, we aimed to investigate the diagnostic performance of FFR derived from the integration of CCTA and invasive angiography (FFR(CT-angio)) with artificial intelligence assistance in patients with stable coronary artery disease (CAD). METHODS: Forty stable CAD patients with 67 target vessels (50%–90% diameter stenosis) were included in this single-center retrospective study. All patients underwent CCTA followed by coronary angiography with FFR measurement within 30 days. Both CCTA and angiographic images were combined to generate a three-dimensional reconstruction of the coronary arteries using artificial intelligence. Subsequently, functional assessment was performed through a deep learning algorithm. FFR was used as the reference. RESULTS: FFR(CT-angio) values were significantly correlated with FFR values (r = 0.81, P < 0.001, Spearman analysis). Per-vessel diagnostic accuracy of FFR(CT-angio) was 92.54%. Sensitivity and specificity in identifying ischemic lesions were 100% and 88.10%, respectively. Positive predictive value and negative predictive value were 83.33% and 100%, respectively. Moreover, the diagnostic performance of FFR(CT-angio) was satisfactory in different target vessels and different segment lesions. CONCLUSIONS: FFR(CT-angio) exhibits excellent diagnostic performance of identifying ischemic lesions in patients with stable CAD. Combining CCTA and angiographic imaging, FFR(CT-angio) may represent an effective and practical alternative to invasive FFR in selected patients. Sciendo 2022-06-10 /pmc/articles/PMC9901557/ /pubmed/36776233 http://dx.doi.org/10.2478/jtim-2022-0018 Text en © 2022 Jingyi Xue, Jianqiang Li, Danghui Sun, Li Sheng, Yongtai Gong, Dingyu Wang, Song Zhang, Yilun Zou, Jing Shi, Wei Xu, Mengnan An, Chenguang Dai, Weimin Li, Linqun Zheng, Asiia Vinograd, Guangzhong Liu, Yihui Kong, Yue Li, published by Sciendo https://creativecommons.org/licenses/by-nc-nd/3.0/This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License. |
spellingShingle | Original Article Xue, Jingyi Li, Jianqiang Sun, Danghui Sheng, Li Gong, Yongtai Wang, Dingyu Zhang, Song Zou, Yilun Shi, Jing Xu, Wei An, Mengnan Dai, Chenguang Li, Weimin Zheng, Linqun Vinograd, Asiia Liu, Guangzhong Kong, Yihui Li, Yue Functional Evaluation of Intermediate Coronary Lesions with Integrated Computed Tomography Angiography and Invasive Angiography in Patients with Stable Coronary Artery Disease |
title | Functional Evaluation of Intermediate Coronary Lesions with Integrated Computed Tomography Angiography and Invasive Angiography in Patients with Stable Coronary Artery Disease |
title_full | Functional Evaluation of Intermediate Coronary Lesions with Integrated Computed Tomography Angiography and Invasive Angiography in Patients with Stable Coronary Artery Disease |
title_fullStr | Functional Evaluation of Intermediate Coronary Lesions with Integrated Computed Tomography Angiography and Invasive Angiography in Patients with Stable Coronary Artery Disease |
title_full_unstemmed | Functional Evaluation of Intermediate Coronary Lesions with Integrated Computed Tomography Angiography and Invasive Angiography in Patients with Stable Coronary Artery Disease |
title_short | Functional Evaluation of Intermediate Coronary Lesions with Integrated Computed Tomography Angiography and Invasive Angiography in Patients with Stable Coronary Artery Disease |
title_sort | functional evaluation of intermediate coronary lesions with integrated computed tomography angiography and invasive angiography in patients with stable coronary artery disease |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9901557/ https://www.ncbi.nlm.nih.gov/pubmed/36776233 http://dx.doi.org/10.2478/jtim-2022-0018 |
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