Diagnostic performance of on-site coronary CT angiography–derived fractional flow reserve based on patient-specific lumped parameter models

Abstract

Purpose To evaluate the diagnostic performance of a prototype on-site coronary CT angiography–derived fractional flow reserve (CT FFR) algorithm, based on patient-specific lumped parameter models, for the detection of functionally significant stenosis defined by invasive FFR, and to compare the performance to anatomic evaluation of stenosis degree. Materials and Methods In this retrospective feasibility study, 77 vessels in 57 patients (42 of 57 [74%]) men; mean age, 58.5 years ± 9.2 [standard deviation]) who underwent clinically indicated coronary CT angiography within 60 days prior to an invasive FFR measurement were analyzed. Invasive FFR less than or equal to 0.80 was used to indicate a functionally significant stenosis. Diagnostic performance of CT FFR was evaluated and compared with evaluation of stenosis degree. Analysis was performed on a per-vessel basis. Results Invasive FFR revealed functionally significant stenoses in 37 vessels (48%). CT FFR showed a significantly increased ability to indicate functionally significant stenosis (area under the receiver operating characteristic curve [AUC], 0.87) compared with degree of stenosis at coronary CT angiography (AUC, 0.70; ΔAUC 0.17; P