Diagnostic performance of fractional flow reserve derived from coronary CT angiography for detection of lesion-specific ischemia: A multi-center study and meta-analysis
| Autor: | Chang Sheng Zhou, Guangming Lu, Jian Hua Li, Lei Xu, Fan Zhou, Meng Jie Lu, Xiao Lei Zhang, Jing Yan, Yan Yi, Robert E. Stroud, Dai-Min Zhang, Chun Xiang Tang, U. Joseph Schoepf, Long Jiang Zhang, Marly van Assen, Yi Ning Wang |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Computed Tomography Angiography Myocardial Ischemia Ischemia Coronary Artery Disease Fractional flow reserve Coronary Angiography Sensitivity and Specificity 030218 nuclear medicine & medical imaging Machine Learning Lesion Coronary artery disease 03 medical and health sciences 0302 clinical medicine medicine Humans Radiology Nuclear Medicine and imaging Retrospective Studies business.industry Reproducibility of Results Coronary ct angiography General Medicine Middle Aged medicine.disease Fractional Flow Reserve Myocardial Multicenter study 030220 oncology & carcinogenesis Meta-analysis Multi center study Female Radiology medicine.symptom business Algorithms |
| Zdroj: | European Journal of Radiology. 116:90-97 |
| ISSN: | 0720-048X |
| DOI: | 10.1016/j.ejrad.2019.04.011 |
| Popis: | Purpose To evaluate the diagnostic performance of coronary computed tomography angiography derived fractional flow reserve (CT-FFR) with invasive fractional flow reserve (FFR) in patients with coronary artery disease" before "with invasive fractional flow reserve serving as the reference standard. Materials and methods CT-FFR values based on a machine learning algorithm (cFFRML) in 183 vessels of 136 patients from four centers were measured with invasive FFR as reference standard. The diagnostic performance from our multicenter study was combined into a meta-analysis following a literature search in Web of Science, PubMed, Cochrane library to identify studies comparing diagnostic performance of coronary computed tomography angiography (CCTA) and CT-FFR. Sensitivity, specificity, accuracy were analyzed on both per-vessel and per-patient basis for intermediate lesions and by algorithm. Results Our multicenter study demonstrated sensitivities, specificities, and accuracies of cFFRML and CCTA of 0.85, 0.94, 0.90, and 0.95, 0.28, 0.55 on a per-vessel basis, respectively. For our meta-analysis, pooled sensitivities, specificities, and accuracies of CT-FFR and CCTA were 0.85, 0.82, 0.82, and 0.85, 0.57, 0.65 with AUC of 0.86 (95%CI: 0.83˜0.89) and 0.83 (95%CI: 0.79˜0.86) on a per-vessel basis, respectively. The sensitivity, specificity and accuracy for intermediate lesions using cFFRML were 0.84, 0.92, and 0.89. No significant difference was found among different algorithms of CT-FFR (P Conslusion This multicenter study with meta-analysis showed that CT-FFR had a high diagnostic accuracy in determining ischemia-specific lesions and intermediate lesions. There was no significant difference when comparing the combined diagnostic performance of different algorithms of CT-FFR with invasive FFR as the reference standard. |
| Databáze: | OpenAIRE |
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