Impact of machine-learning CT-derived fractional flow reserve for the diagnosis and management of coronary artery disease in the randomized CRESCENT trials

Autor: Tobias Bruning, Ricardo P.J. Budde, Tjebbe W. Galema, Jurgen Akkerhuis, Isabella Kardys, Koen Nieman, Marcel J.M. Kofflard, Bas L.J.H. Kietselaer, Yuzo Yamasaki, Marisa Lubbers, Fay M.A. Nous
Přispěvatelé: Cardiology, Radiology & Nuclear Medicine
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
medicine.medical_specialty
Cardiac Catheterization
Computed Tomography Angiography
Fractional flow reserve
Coronary Artery Disease
Coronary Angiography
Article
030218 nuclear medicine & medical imaging
Coronary artery disease
Cohort Studies
Machine Learning
03 medical and health sciences
Myocardial perfusion imaging
0302 clinical medicine
Percutaneous Coronary Intervention
Medicine
Humans
Radiology
Nuclear Medicine and imaging
Neuroradiology
Computed tomography angiography
Aged
Retrospective Studies
medicine.diagnostic_test
business.industry
Coronary Stenosis
Hemodynamics
Disease Management
Interventional radiology
General Medicine
Middle Aged
medicine.disease
Fractional Flow Reserve
Myocardial
Stenosis
030220 oncology & carcinogenesis
Female
Radiology
business
Tomography
X-Ray Computed
Cohort study
Zdroj: European Radiology, 30(7), 3692-3701. Springer-Verlag
Eur Radiol
ISSN: 1432-1084
0938-7994
Popis: To determine the potential impact of on-site CT-derived fractional flow reserve (CT-FFR) on the diagnostic efficiency and effectiveness of coronary CT angiography (CCTA) in patients with obstructive coronary artery disease (CAD) on CCTA. This observational cohort study included patients with suspected CAD who had been randomized to cardiac CT in the CRESCENT I and II trials. On-site CT-FFR was blindly performed in all patients with at least one ≥ 50% stenosis on CCTA and no exclusion criteria for CT-FFR. We retrospectively assessed the effect of adding CT-FFR to the CT protocol in patients with a stenosis ≥ 50% on CCTA in terms of diagnostic effectiveness, i.e., the number of additional tests required to determine the final diagnosis, reclassification of the initial management strategy, and invasive coronary angiography (ICA) efficiency, i.e., ICA rate without ≥ 50% CAD. Fifty-three patients out of the 372 patients (14%) had at least one ≥ 50% stenosis on CCTA of whom 42/53 patients (79%) had no exclusion criteria for CT-FFR. CT-FFR showed a hemodynamically significant stenosis (≤ 0.80) in 27/53 patients (51%). The availability of CT-FFR would have reduced the number of patients requiring additional testing by 57%-points compared with CCTA alone (37/53 vs. 7/53, p
Databáze: OpenAIRE
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