Diagnostic performance of noninvasive fractional flow reserve derived from coronary computed tomography angiography in ischemia-causing coronary stenosis: a meta-analysis

Ding, Aimin; Qiu, Guibao; Lin, Wensheng; Hu, Ling; Lu, Guangliang; Xiang, Long; Hong, Xin; Chen, Yaohua; Xiao-ping, Luo; Tang, Qinqin; Deng, Dongqin

doi:10.1007/s11604-016-0589-4

Cited by 6 publications

(1 citation statement)

References 42 publications

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“…[10][11][12] Ultimately, this novel technique allows for comprehensive anatomic and physiologic diagnosis of coronary artery disease (CAD). 13 However, current non-invasive FFR techniques have several major limitations when applied to day-to-day clinical practice: The required simulation has to be performed outside of the hospital because it necessitates a supercomputer, therefore requiring transfer of patient data potentially leading to exposure of personal patient information. 14 Furthermore, the processing time can take several hours, and the service can be expensive.…”

Section: Diagnostic Accuracy Of a Novel On-site Virtual Fractional Flow Reserve Parallel Computing Systemmentioning

confidence: 99%

Diagnostic Accuracy of a Novel On-site Virtual Fractional Flow Reserve Parallel Computing System

et al. 2020

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Purpose: To evaluate the diagnostic accuracy of a novel on-site virtual fractional flow reserve (vFFR) derived from coronary computed tomography angiography (CTA). Materials and Methods: We analyzed 100 vessels from 57 patients who had undergone CTA followed by invasive FFR during coronary angiography. Coronary lumen segmentation and three-dimensional reconstruction were conducted using a completely automated algorithm, and parallel computing based vFFR prediction was performed. Lesion-specific ischemia based on FFR was defined as significant at ≤0.8, as well as ≤0.75, and obstructive CTA stenosis was defined that ≥50%. The diagnostic performance of vFFR was compared to invasive FFR at both ≤0.8 and ≤0.75. Results: The average computation time was 12 minutes per patient. The correlation coefficient (r) between vFFR and invasive FFR was 0.75 [95% confidence interval (CI) 0.65 to 0.83], and Bland-Altman analysis showed a mean bias of 0.005 (95% CI -0.011 to 0.021) with 95% limits of agreement of -0.16 to 0.17 between vFFR and FFR. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were 78.0%, 87.1%, 72.5%, 58.7%, and 92.6%, respectively, using the FFR cutoff of 0.80. They were 87.0%, 95.0%, 80.0%, 54.3%, and 98.5%, respectively, with the FFR cutoff of 0.75. The area under the receiver-operating characteristics curve of vFFR versus obstructive CTA stenosis was 0.88 versus 0.61 for the FFR cutoff of 0.80, respectively; it was 0.94 versus 0.62 for the FFR cutoff of 0.75. Conclusion: Our novel, fully automated, on-site vFFR technology showed excellent diagnostic performance for the detection of lesion-specific ischemia.

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Section: Diagnostic Accuracy Of a Novel On-site Virtual Fractional Flow Reserve Parallel Computing Systemmentioning

confidence: 99%

Diagnostic Accuracy of a Novel On-site Virtual Fractional Flow Reserve Parallel Computing System

et al. 2020

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Additional diagnostic value of new CT imaging techniques for the functional assessment of coronary artery disease: a meta-analysis

et al. 2019

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Umbrella review and multivariate meta-analysis of diagnostic test accuracy studies on hybrid non-invasive imaging for coronary artery disease

Biondi‐Zoccai

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Iskandrian

et al. 2020

Journal of Nuclear Cardiology

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Background. The diagnosis of coronary artery disease (CAD) remains challenging. It is uncertain whether hybrid imaging can improve diagnostic accuracy for CAD. Methods. This is a systematic review and multivariate meta-analysis. We searched PubMed and The Cochrane Library for recent (‡ 2010) systematic reviews of diagnostic test accuracy studies on non-invasive imaging for CAD. Study-level data were extracted from them, and pooled with pairwise and multivariate meta-analytic methods, using invasive coronary angiography (ICA) or invasive fractional flow reserve (FFR) as reference standards, focusing on sensitivity and specificity. Results. Details from 661 original studies (71,823 patients) were pooled. Pairwise metaanalysis using ICA as reference showed that anatomic imaging was associated with the best diagnostic accuracy (sensitivity = 0.95 [95% confidence interval 0.94-0.96], specificity = 0.83 [0.81-0.85]), whereas using FFR as reference identified hybrid imaging as the best test (sensitivity = 0.87 [0.83-0.90], specificity = 0.82 [0.76-0.87]). Multivariate meta-analysis confirmed the superiority of anatomic imaging using ICA as reference (sensitivity = 0.96, specificity = 0.83), and hybrid imaging using FFR as reference (sensitivity = 0.88 [0.86-0.91], specificity = 0.82 [0.77-0.87]). Conclusions. Non-invasive hybrid imaging tests appear superior to anatomic or functional only tests to diagnose ischemia-provoking coronary lesions, whereas anatomic imaging is best to Electronic supplementary material The online version of this article (

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Diagnostic performance of noninvasive fractional flow reserve derived from coronary computed tomography angiography in ischemia-causing coronary stenosis: a meta-analysis

Abstract: This study indicates that FFR may be a good tool for screening and diagnosing of myocardial ischemia in patients with CAD.

Cited by 6 publications

References 42 publications

Diagnostic Accuracy of a Novel On-site Virtual Fractional Flow Reserve Parallel Computing System

Diagnostic Accuracy of a Novel On-site Virtual Fractional Flow Reserve Parallel Computing System

Additional diagnostic value of new CT imaging techniques for the functional assessment of coronary artery disease: a meta-analysis

Umbrella review and multivariate meta-analysis of diagnostic test accuracy studies on hybrid non-invasive imaging for coronary artery disease

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