scholarly journals P2969Comparison of diagnostic performance of cadmium-zinc-telluride camera system between 201Tl and 99mTc-radiotracers as assessed by fractional flow reserve

2017 ◽  
Vol 38 (suppl_1) ◽  
Author(s):  
S. Hida ◽  
T. Chikamori ◽  
Y. Igarashi ◽  
T. Saitoh ◽  
K. Hirose ◽  
...  
Keyword(s):  
Fractional Flow Reserve ◽  
Diagnostic Performance ◽  
Cadmium Zinc Telluride ◽  
Zinc Telluride ◽  
Fractional Flow ◽  
Camera System ◽  
Flow Reserve ◽  
Cadmium Zinc

scholarly journals Diagnostic Performance of a Novel Cadmium-Zinc-Telluride Gamma Camera System Assessed Using Fractional Flow Reserve

2014 ◽  
Vol 78 (11) ◽  
pp. 2727-2734 ◽  
Author(s):  
Hirokazu Tanaka ◽  
Taishiro Chikamori ◽  
Nobuhiro Tanaka ◽  
Satoshi Hida ◽  
Yuko Igarashi ◽  
...  
Keyword(s):  
Fractional Flow Reserve ◽  
Diagnostic Performance ◽  
Gamma Camera ◽  
Cadmium Zinc Telluride ◽  
Zinc Telluride ◽  
Fractional Flow ◽  
Camera System ◽  
Flow Reserve ◽  
Cadmium Zinc

P6175Prediction of coronary revascularization by coronary computed tomography angiography derived fractional flow reserve - different algorithms for interpretation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K T Madsen ◽  
K T Veien ◽  
B L Noergaard ◽  
P Larsen ◽  
L Deibjerg ◽  
...  
Keyword(s):  
Chest Pain ◽  
Fractional Flow Reserve ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Coronary Revascularization ◽  
Standard Of Care ◽  
Fractional Flow ◽  
Coronary Cta ◽  
Flow Reserve ◽  
Stable Chest Pain

Abstract Introduction Coronary CT angiography (CTA) derived fractional flow reserve (FFRct) is increasingly used for guiding referral to invasive procedures in patients with stable chest pain. However, optimal interpretation of FFRct-analysis in terms of location and threshold of applied FFRct-values is unclear. Purpose To evaluate the clinical performance of various vessel-specific physiological FFRct derived measures of ischemia for prediction of standard of care guided coronary revascularization in patients with stable chest pain and coronary artery disease as determined by coronary CTA. Methods Retrospective study in patients with stable chest pain referred for coronary angiography based on coronary CTA. Standard acquired coronary CTA data sets were transmitted for core-laboratory analysis at HeartFlow. Any FFRct value in the major coronary arteries ≥1.8 mm in diameter, including side branches, were registered. Lesions were categorized as positive for ischemia using 6 different algorithms: Lowest in vessel FFRct-value (1) ≤0.75 or (2) ≤0.80; 2 cm distal-to-lesion FFRct-value (3) ≤0.75 or (4) ≤0.80; ΔFFRct (5) ≥0.06 or a combination of 2 and 5. The personnel responsible for downstream patient management had no information regarding FFRct test results. Results A total of 172 patients were included. Revascularization was performed in 62 (35%) patients. The diagnostic performance of different FFRct algorithms for predicting standard of care guided coronary revascularization is shown in the Table. Revascularization Predictions by FFRct N=172 Diagnostic performance FFRCT false negative FFRCT false positive Values given as (%) No. of revasc vessels No. of abnormal vessels FFRCT Algorithm Sens Spec PPV NPV Acc 1 2 3 1 2 3 Distal FFRCT ≤0.75 77 68 58 84 72 12 2 0 29 5 1 Distal FFRCT ≤0.80 92 43 48 90 61 5 0 0 40 20 3 Lesion-specific FFRCT ≤0.75 68 86 74 83 80 17 3 0 12 3 0 Lesion-specific FFRCT ≤0.80 82 78 68 89 80 10 2 0 21 3 1 ΔFFRCT ≥0.06 98 36 47 98 59 1 0 0 51 19 0 Combinationa 92 54 53 92 67 5 0 0 39 12 0 aDistal FFRCT ≤0.80 and ΔFFRCT ≥0.06. Sens = sensitivity; Spec = specificity; PPV = positive predictive value; NPV = negative predictive value; Acc = accuracy; FFRCT = fractional flow reserve derived from coronary CTA; ΔFFRCT = difference between FFRCT-value immediately proximal and distal to lesion; Revasc = revascularized. Conclusion The diagnostic performance of FFRct in terms of predicting standard of care guided coronary revascularization is dependent on the applied algorithm for interpretation of the FFRct-analysis.

scholarly journals Meta-Analysis of Diagnostic Performance of Contrast-Fractional Flow Reserve versus Quantitative Flow Ratio for Functional Assessment of Coronary Stenoses

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Ruitao Zhang ◽  
Jianwei Zhang ◽  
Lijun Guo
Keyword(s):  
Sensitivity And Specificity ◽  
Fractional Flow Reserve ◽  
Coronary Stenosis ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Flow Ratio ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow

Background. Use of the fractional flow reserve (FFR) technique is recommended to evaluate coronary stenosis severity and guide revascularization. However, its high cost, time to administer, and the side effects of adenosine reduce its clinical utility. Two novel adenosine-free indices, contrast-FFR (cFFR) and quantitative flow ratio (QFR), can simplify the functional evaluation of coronary stenosis. This study aimed to analyze the diagnostic performance of cFFR and QFR using FFR as a reference index. Methods. We conducted a systematic review and meta-analysis of observational studies in which cFFR or QFR was compared to FFR. A bivariate model was applied to pool diagnostic parameters. Cochran’s Q test and the I2 index were used to assess heterogeneity and identify the potential source of heterogeneity by metaregression and sensitivity analysis. Results. Overall, 2220 and 3000 coronary lesions from 20 studies were evaluated by cFFR and QFR, respectively. The pooled sensitivity and specificity were 0.87 (95% CI: 0.81, 0.91) and 0.92 (95% CI: 0.88, 0.94) for cFFR and 0.87 (95% CI: 0.82, 0.91) and 0.91 (95% CI: 0.87, 0.93) for QFR, respectively. No statistical significance of sensitivity and specificity for cFFR and QFR were observed in the bivariate analysis (P=0.8406 and 0.4397, resp.). The area under summary receiver-operating curve of cFFR and QFR was 0.95 (95% CI: 0.93, 0.97) for cFFR and 0.95 (95% CI: 0.93, 0.97). Conclusion. Both cFFR and QFR have good diagnostic performance in detecting functional severity of coronary arteries and showed similar diagnostic parameters.

scholarly journals Accuracy of computational pressure-fluid dynamics applied to coronary angiography to derive fractional flow reserve: FLASH FFR

2019 ◽  
Vol 116 (7) ◽  
pp. 1349-1356 ◽  
Author(s):  
Jianping Li ◽  
Yanjun Gong ◽  
Weimin Wang ◽  
Qing Yang ◽  
Bin Liu ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Fractional Flow Reserve ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Characteristic Curve ◽  
Fractional Flow ◽  
Performance Goal ◽  
Flow Reserve

Abstract Aims Conventional fractional flow reserve (FFR) is measured invasively using a coronary guidewire equipped with a pressure sensor. A non-invasive derived FFR would eliminate risk of coronary injury, minimize technical limitations, and potentially increase adoption. We aimed to evaluate the diagnostic performance of a computational pressure-flow dynamics derived FFR (caFFR), applied to coronary angiography, compared to invasive FFR. Methods and results The FLASH FFR study was a prospective, multicentre, single-arm study conducted at six centres in China. Eligible patients had native coronary artery target lesions with visually estimated diameter stenosis of 30–90% and diagnosis of stable or unstable angina pectoris. Using computational pressure-fluid dynamics, in conjunction with thrombolysis in myocardial infarction (TIMI) frame count, applied to coronary angiography, caFFR was measured online in real-time and compared blind to conventional invasive FFR by an independent core laboratory. The primary endpoint was the agreement between caFFR and FFR, with a pre-specified performance goal of 84%. Between June and December 2018, matched caFFR and FFR measurements were performed in 328 coronary arteries. Total operational time for caFFR was 4.54 ± 1.48 min. caFFR was highly correlated to FFR (R = 0.89, P = 0.76) with a mean bias of −0.002 ± 0.049 (95% limits of agreement −0.098 to 0.093). The diagnostic performance of caFFR vs. FFR was diagnostic accuracy 95.7%, sensitivity 90.4%, specificity 98.6%, positive predictive value 97.2%, negative predictive value 95.0%, and area under the receiver operating characteristic curve of 0.979. Conclusions Using wire-based FFR as the reference, caFFR has high accuracy, sensitivity, and specificity. caFFR could eliminate the need of a pressure wire, technical error and potentially increase adoption of physiological assessment of coronary artery stenosis severity. Clinical Trial Registration URL: http://www.chictr.org.cn Unique Identifier: ChiCTR1800019522.

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