Non‐invasive coronary computed tomography (CT) angiography‐derived fractional flow reserve (cFFR) is an emergent approach to determine the functional relevance of obstructive coronary lesions. Its feasibility and diagnostic performance has been reported in several studies. It is unclear if differences in sensitivity and specificity between these studies are due to study design, population, or "computational methodology." We evaluate the diagnostic performance of four different computational workflows for the prediction of cFFR using a limited data set of 10 patients, three based on reduced‐order modelling and one based on a 3D rigid‐wall model. The results for three of these methodologies yield similar accuracy of 6.5% to 10.5% mean absolute difference between computed and measured FFR. The main aspects of modelling which affected cFFR estimation were choice of inlet and outlet boundary conditions and estimation of flow distribution in the coronary network. One of the reduced‐order models showed the lowest overall deviation from the clinical FFR measurements, indicating that reduced‐order models are capable of a similar level of accuracy to a 3D model. In addition, this reduced‐order model did not include a lumped pressure‐drop model for a stenosis, which implies that the additional effort of isolating a stenosis and inserting a pressure‐drop element in the spatial mesh may not be required for FFR estimation. The present benchmark study is the first of this kind, in which we attempt to homogenize the data required to compute FFR using mathematical models. The clinical data utilised in the cFFR workflows are made publicly available online.

The paper addresses methods for generation of individualized computational domains on the basis of medical imaging dataset. The computational domains will be used in one-dimensional (1D) and three-dimensional (3D)-1D coupled hemodynamic models. A 1D hemodynamic model employs a 1D network of a patient-specific vascular network with large number of vessels. The 1D network is the graph with nodes in the 3D space which bears additional geometric data such as length and radius of vessels. A 3D hemodynamic model requires a detailed 3D reconstruction of local parts of the vascular network. We propose algorithms which extend the automated segmentation of vascular and tubular structures, generation of centerlines, 1D network reconstruction, correction, and local adaptation. We consider two modes of centerline representation: (i) skeletal segments or sets of connected voxels and (ii) curved paths with corresponding radii. Individualized reconstruction of 1D networks depends on the mode of centerline representation. Efficiency of the proposed algorithms is demonstrated on several examples of 1D network reconstruction. The networks can be used in modeling of blood flows as well as other physiological processes in tubular structures. Copyright © 2015 John Wiley & Sons, Ltd.