CT fractional flow reserve: the next level in non-invasive cardiac imaging

Meijs, Matthijs F.L.; Aidi, Hamza El; Doevendans, Pieter A.

doi:10.1007/s12471-012-0306-6

Cited by 17 publications

(13 citation statements)

References 68 publications

(91 reference statements)

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“…However, without automated image processing, TAG remains a time-consuming method [22]. Two recent multicenter trials used computational fluid dynamics to estimate lesion-specific FFR [7,9,23] by calculating the ratio of coronary pressure and mean aortic pressure. It was demonstrated that non-invasive FFR measurement was superior to cCTA for diagnosing ischemic lesions [24].…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic significance of coronary stenosis by vessel attenuation measurement on CT compared with adenosine perfusion MRI

Dekker

Pelgrim

Pundziūtė

et al. 2015

European Journal of Radiology

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Section: Discussionmentioning

confidence: 99%

Hemodynamic significance of coronary stenosis by vessel attenuation measurement on CT compared with adenosine perfusion MRI

Dekker

Pelgrim

Pundziūtė

et al. 2015

European Journal of Radiology

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“…Although CCS is proven to be a valuable tool to detect coronary calcification, it is unable to differentiate media calcification, which is common in patients with CKD, from intima calcification. Moreover, whether the use of computed tomography fractional flow reserve will provide additional diagnostic information in patients with CKD would require further studies [27]. …”

Section: Limitationmentioning

confidence: 99%

Different value of coronary calcium score to predict obstructive coronary artery disease in patients with and without moderate chronic kidney disease

et al. 2013

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PurposeThe coronary calcium score (CCS) predicts significant coronary artery disease (CAD) in the general population. While moderate chronic kidney disease (CKD) is associated with high CCS, the use of CCS to predict significant CAD in these patients is unknown.MethodsA total of 704 patients underwent computed tomography coronary angiography for the assessment of CCS and CAD. Sixty-nine (10 %) patients had moderate CKD, defined by an estimated glomerular filtration rate (eGFR) between 30 and 59 mL/min/1.73m2, and the remaining patients were considered to be without significant CKD (eGFR ≥ 60 mL/min/1.73m2).ResultsPatients with moderate CKD were older, had a higher CCS, and a higher prevalence of obstructive CAD than patients without significant CKD. Receiver-operator curve analysis showed that CCS predicted the presence of obstructive CAD in both patients with moderate CKD and those without significant CKD. In patients with moderate CKD, the optimal cut-off value of CCS to diagnose obstructive CAD was 140 (sensitivity 73 % and specificity of 70 %), and is 2.8 fold higher than in patients without significant CKD (cut-off value = 50; sensitivity 75 % and specificity 75 %).ConclusionThe present results demonstrate that CCS can predict obstructive CAD in patients with moderate CKD, although the optimal cut-off value is higher than in patients without significant CKD.

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“…This is achieved by simulating coronary blood flow using computational fluid dynamics (CFD) based on lumen geometry extracted from CCTA. Latest studies show that CFD provides a better accuracy in identifying ischemia-causing stenoses than the anatomical grade [8]. Both grading and CFD heavily depend on the accuracy of the extracted coronary lumen.…”

Section: Introductionmentioning

confidence: 99%

Precise Lumen Segmentation in Coronary Computed Tomography Angiography

Lugauer

Zheng

Hornegger

et al. 2014

Medical Computer Vision: Algorithms for Big Data

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Abstract. Coronary computed tomography angiography (CCTA) allows for non-invasive identification and grading of stenoses by evaluating the degree of narrowing of the blood-filled vessel lumen. Recently, methods have been proposed that simulate coronary blood flow using computational fluid dynamics (CFD) to compute the fractional flow reserve non-invasively. Both grading and CFD rely on a precise segmentation of the vessel lumen from CCTA. We propose a novel, model-guided segmentation approach based on a Markov random field formulation with convex priors which assures the preservation of the tubular structure of the coronary lumen. Allowing for various robust smoothness terms, the approach yields very accurate lumen segmentations even in the presence of calcified and non-calcified plaques. Evaluations on the public Rotterdam segmentation challenge demonstrate the robustness and accuracy of our method: on standardized tests with multi-vendor CCTA from 30 symptomatic patients, we achieve superior accuracies as compared to both state-of-the-art methods and medical experts.

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CT fractional flow reserve: the next level in non-invasive cardiac imaging

Cited by 17 publications

References 68 publications

Hemodynamic significance of coronary stenosis by vessel attenuation measurement on CT compared with adenosine perfusion MRI

Hemodynamic significance of coronary stenosis by vessel attenuation measurement on CT compared with adenosine perfusion MRI

Different value of coronary calcium score to predict obstructive coronary artery disease in patients with and without moderate chronic kidney disease

Precise Lumen Segmentation in Coronary Computed Tomography Angiography

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