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Coronary CT angiography-derived plaque quantification with artificial intelligence CT fractional flow reserve for the identification of lesion-specific ischemia

Doeberitz, P. L. V. K., De Cecco, C. N., Schoepf, U. J., Duguay, T. M., Albrecht, M. H., van Assen, M., Bauer, M. J., Savage, R. H., Pannell, J. T., De Santis, D., Johnson, A. A., Varga-Szemes, A., Bayer, R. R., Schoenberg, S. O., Nance, J. W. & Tesche, C., May-2019, In : European Radiology. 29, 5, p. 2378-2387 10 p.

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  • Coronary CT angiography–derived plaque quantification with artificial intelligence CT fractional flow reserve for the identification of lesion-specific ischemia

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DOI

  • Philipp L. von Knebel Doeberitz
  • Carlo N. De Cecco
  • U. Joseph Schoepf
  • Taylor M. Duguay
  • Moritz H. Albrecht
  • Marly van Assen
  • Maximilian J. Bauer
  • Rock H. Savage
  • J. Trent Pannell
  • Domenico De Santis
  • Addison A. Johnson
  • Akos Varga-Szemes
  • Richard R. Bayer
  • Stefan O. Schoenberg
  • John W. Nance
  • Christian Tesche

ObjectivesWe sought to investigate the diagnostic performance of coronary CT angiography (cCTA)-derived plaque markers combined with deep machine learning-based fractional flow reserve (CT-FFR) to identify lesion-specific ischemia using invasive FFR as the reference standard.MethodsEighty-four patients (6110years, 65% male) who had undergone cCTA followed by invasive FFR were included in this single-center retrospective, IRB-approved, HIPAA-compliant study. Various plaque markers were derived from cCTA using a semi-automatic software prototype and deep machine learning-based CT-FFR. The discriminatory value of plaque markers and CT-FFR to identify lesion-specific ischemia on a per-vessel basis was evaluated using invasive FFR as the reference standard.ResultsOne hundred three lesion-containing vessels were investigated. 32/103 lesions were hemodynamically significant by invasive FFR. In a multivariate analysis (adjusted for Framingham risk score), the following markers showed predictive value for lesion-specific ischemia (odds ratio [OR]): lesion length (OR 1.15, p=0.037), non-calcified plaque volume (OR 1.02, p=0.007), napkin-ring sign (OR 5.97, p=0.014), and CT-FFR (OR 0.81, p

Original languageEnglish
Pages (from-to)2378-2387
Number of pages10
JournalEuropean Radiology
Volume29
Issue number5
Publication statusPublished - May-2019

    Keywords

  • Spiral computed tomography, Coronary artery disease, Angiography, COMPUTED-TOMOGRAPHY ANGIOGRAPHY, INCREMENTAL PROGNOSTIC VALUE, ASSOCIATION TASK-FORCE, AMERICAN-COLLEGE, ATHEROSCLEROTIC LESIONS, DIAGNOSTIC PERFORMANCE, ARTERY-DISEASE, PREDICTION, GUIDELINES, BURDEN

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