Effect of image quality on diagnostic accuracy of noninvasive fractional flow reserve: Results from the prospective multicenter international DISCOVER-FLOW study

Min, James K.; Koo, Bon‐Kwon; Ērglis, Andrejs; Doh, Joon Hyung; Daniels, David; Jēgere, Sanda; Kim, Hyo–Soo; Dunning, Allison; DeFrance, Tony; Leipsic, Jonathan

doi:10.1016/j.jcct.2012.04.010

Cited by 93 publications

(59 citation statements)

References 24 publications

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“…Accordingly, it has been shown that even at lower coronary CTA image quality, FFRCT continues to provide significant improvement when compared with coronary CTA. 24 Moreover, it is anticipated that further refinements in CT technology and FFRCT analysis may reduce the impact of CT artifacts. Third, patients with acute coronary syndrome and previous coronary intervention or bypass surgery were excluded from the present study.…”

Section: Ffr From Ct: Japanese Nxt Trial Resultsmentioning

confidence: 99%

Non-Invasive Computed Fractional Flow Reserve From Computed Tomography (CT) for Diagnosing Coronary Artery Disease

Miyoshi

Osawa

Ito

et al. 2015

Circ J

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Section: Ffr From Ct: Japanese Nxt Trial Resultsmentioning

confidence: 99%

Non-Invasive Computed Fractional Flow Reserve From Computed Tomography (CT) for Diagnosing Coronary Artery Disease

Miyoshi

Osawa

Ito

et al. 2015

Circ J

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“…4,21 This expands the usefulness of coronary CTA by combining anatomic and functional assessment and raises the potential of coronary CTA to help define those patients that may derive benefit from invasive angiography and possible revascularization. Furthermore, FFR CT analysis provides functional information at all locations in the coronary tree adding a richness of information which may be useful in clinical decision making.…”

Section: Discussionmentioning

confidence: 97%

Diagnostic accuracy and discrimination of ischemia by fractional flow reserve CT using a clinical use rule: Results from the Determination of Fractional Flow Reserve by Anatomic Computed Tomographic Angiography study

Thompson

Raju

Blanke

et al. 2015

Journal of Cardiovascular Computed Tomography

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“…Currently, several vendors provide on-site FFR-CT applications, which may increase the applicability of the technology in clinical and research settings [17,18]. However, computation of FFR-CT is dependent on CTA image quality [19], and further studies may be required, especially in the presence of heavily calcified plaques and prior stents.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of Stress-Alone Cardiac CT for Detecting Hemodynamically Significant Coronary Stenosis in the Presence of High Coronary Calcium Score and Coronary Stents

Nakamori

Kitagawa

Tsuruo

et al. 2017

Cardiovasc Imaging Asia

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Objective: Coronary computed tomographic angiography (CTA), including rest and stress myocardial perfusion computed tomography (CTP), allows for comprehensive assessment of flowlimiting coronary artery disease (CAD). In patients with severe coronary calcification or prior coronary stents where rest CTA had limited accuracy, stress CTP with coronary artery assessment on the same stress CTP dataset (stress-alone CTP/CTA) without rest CTA may be a valuable protocol. We assessed the diagnostic performance of stress-alone CTP/CTA with 320-slice CT compared to a combination of stress CTP/CTA and rest CTA/CTP using invasively determined fractional flow reserve (FFR) as the reference standard. Materials and Methods:Thirty-five patients with a high calcium score, stratified according to >400 Agatston units and/or prior stents, underwent CT examination starting with stress CTP/CTA and followed by rest CTA/CTP and invasive angiography. FFR <0.80 or luminal stenosis >90% was considered hemodynamically significant.Results: Fifty-six coronary vessels had flow-limiting stenoses. In our vessel-based analysis, integration of rest CTA/CTP with stress CTP/CTA significantly improved diagnostic performance to 82% sensitivity and 96% specificity, with an area under the receiver operator characteristic curve (AUC) of 0.94, compared with 0.90 for stress-alone CTP/CTA. However, according to our per-patient level analysis, stress CTP/CTA yielded its highest diagnostic performance with an AUC of 0.97, which was not an improvement on the integration of rest CTA/CTP. Mean radiation for stress-alone CTP/CTA and combined stress-rest CTA/CTP was 8.0 and 12.7 mSV, respectively. These were relatively high doses but were performed on a first-generation 320-slice CT scanner. Conclusion:A stress-alone CTP/CTA protocol can provide excellent diagnostic performance for predicting flow-limiting CAD in patients with a high calcium score and coronary stents, omitting the need for radiation and contrast medium required for rest CTA/CTP.

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Effect of image quality on diagnostic accuracy of noninvasive fractional flow reserve: Results from the prospective multicenter international DISCOVER-FLOW study

Cited by 93 publications

References 24 publications

Non-Invasive Computed Fractional Flow Reserve From Computed Tomography (CT) for Diagnosing Coronary Artery Disease

Non-Invasive Computed Fractional Flow Reserve From Computed Tomography (CT) for Diagnosing Coronary Artery Disease

Diagnostic accuracy and discrimination of ischemia by fractional flow reserve CT using a clinical use rule: Results from the Determination of Fractional Flow Reserve by Anatomic Computed Tomographic Angiography study

Feasibility of Stress-Alone Cardiac CT for Detecting Hemodynamically Significant Coronary Stenosis in the Presence of High Coronary Calcium Score and Coronary Stents

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