Coronary CT angiography-based FFR with ultrahigh-resolution photon-counting detector CT: Intra-individual comparison to energy-integrating detector CT.

Autor: Vecsey-Nagy M; Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, United States; Heart and Vascular Centre, Semmelweis University, 68 Varosmajor Street, Budapest 1122, Hungary., Tremamunno G; Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, United States; Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome - Sant'Andrea University Hospital, 1035-1039 Via di Grottarossa, Rome 00189, Italy., Schoepf UJ; Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, United States., Gnasso C; Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, United States; Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, 60 Via Olgettina, Milan 20132, Italy., Zsarnóczay E; Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, United States; MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Center, Semmelweis University, 2 Koranyi Sandor Street, Budapest 1083, Hungary., Fink N; Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, United States; Department of Radiology, University Hospital, LMU Munich, 15 Marchioninistraße, Munich 81377, Germany., Kravchenko D; Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, United States; Department of Diagnostic and Interventional Radiology, University Hospital Bonn, 1 Venusberg-Campus, Bonn 53127, Germany., Taha Hagar M; Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, United States; Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, 55 Hugstetter Street, Freiburg im Breisgau 79106, Germany., Halfmann MC; Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University, 1 Langenbeckstraße, Mainz 55131, Germany., Jokkel Z; Heart and Vascular Centre, Semmelweis University, 68 Varosmajor Street, Budapest 1122, Hungary., O'Doherty J; Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, United States; Siemens Medical Solutions USA Inc, 40 Liberty Boulevard, Malvern, PA 19355, United States., Szilveszter B; Heart and Vascular Centre, Semmelweis University, 68 Varosmajor Street, Budapest 1122, Hungary., Maurovich-Horvat P; MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Center, Semmelweis University, 2 Koranyi Sandor Street, Budapest 1083, Hungary., Spruill Suranyi P; Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, United States., Varga-Szemes A; Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, United States. Electronic address: musccvi@musc.edu., Emrich T; Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, United States; Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University, 1 Langenbeckstraße, Mainz 55131, Germany.
Jazyk: angličtina
Zdroj: European journal of radiology [Eur J Radiol] 2024 Oct 19; Vol. 181, pp. 111797. Date of Electronic Publication: 2024 Oct 19.
DOI: 10.1016/j.ejrad.2024.111797
Abstrakt: Purpose: To evaluate the feasibility of CT angiography-derived fractional flow reserve (CT-FFR) calculations on ultrahigh-resolution (UHR) photon-counting detector (PCD)-CT series and to intra-individually compare the results with energy-integrating (EID)-CT measurements.
Method: Prospective patients with calcified plaques detected on EID-CT between April 1st, 2023 and January 31st, 2024 were recruited for a UHR CCTA on PCD-CT within 30 days. PCD-CT was performed using the same or a lower CT dose index and an equivalent volume of contrast media. An on-site machine learning algorithm was used to obtain CT-FFR values on a per-vessel and per-patient basis. For all analyses, CT-FFR values ≤ 0.80 were deemed to be hemodynamically significant.
Results: A total of 34 patients (age: 67.3 ± 6.6 years, 7 women [20.6 %]) were included. Excellent inter-scanner agreement was noted for CT-FFR values in the per-vessel (ICC: 0.93 [0.90-0.95]) and per-patient (ICC: 0.94 [0.88-0.97]) analysis. PCD-CT-derived CT-FFR values proved to be higher compared to EID-CT values on both vessel (0.58 ± 0.23 vs. 0.55 ± 0.23, p < 0.001) and patient levels (0.73 ± 0.23 vs. 0.70 ± 0.22, p < 0.001). Two patients (5.9 %) with hemodynamically significant lesions on EID-CT were reclassified as non-significant on PCD-CT. All remaining participants were classified into the same category with both scanner systems.
Conclusions: While UHR CT-FFR values demonstrate excellent agreement with EID-CT measurements, PCD-CT produces higher CT-FFR values that could contribute to a reclassification of hemodynamic significance.
Competing Interests: Declaration of competing interest Dr. Schoepf receives institutional research support and/or honoraria for speaking and consulting from Bayer, Bracco, Elucid BioImaging, Guerbet, HeartFlow Inc., Keya Medical, and Siemens Healthineers. Dr. Szilveszter and Dr. Maurovich-Horvat receive institutional research and travel support from Siemens Healthineers. Dr. Varga-Szemes receives institutional research and travel support from Siemens Healthineers and is a consultant and shareholder for Elucid Bioimaging. Dr. Emrich is a consultant for Circle Cardiovascular Imaging Inc. and receives travel support, speaker fee and institutional research support from Siemens Healthineers.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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