This article reviews four new technologies for assessment of coronary
hemodynamics based on medical imaging and artificial intelligence, including
quantitative flow ratio (QFR), optical flow ratio (OFR), computational fractional
flow reserve (CT-FFR) and artificial intelligence (AI)-based instantaneous wave-free ratio (iFR). These
technologies use medical imaging such as coronary angiography, computed
tomography angiography (CTA), and optical coherence tomography (OCT), to
reconstruct three-dimensional vascular models through artificial intelligence
algorithms, simulate and calculate hemodynamic parameters in the coronary
arteries, and achieve non-invasive and rapid assessment of the functional
significance of coronary stenosis. This article details the working principles,
advantages such as non-invasiveness, efficiency, accuracy, limitations such as
image dependency, and assumption restrictions, of each technology. It also
compares and analyzes the image dependency, calculation accuracy, calculation
speed, and operation simplicity, of the four technologies. The results show that
these technologies are highly consistent with the traditional invasive wire
method, and shows distinct advantages in terms of accuracy, reliability,
convenience and cost-effectiveness, but there are also factors that affect
accuracy. The results of this review demonstrates that AI-based iFR technology is
currently one of the most promising technologies. The main challenges and
directions for future development are also discussed. These technologies bring
new ideas for the non-invasive assessment of coronary artery disease, and are
expected to promote the technological progress in this field.