Novel fast FFR derived from coronary CT angiography based on static first-pass algorithm: a comparison study

Lin YANG; Wen-Jia WANG; Chao XU; Tao BI; Yi-Ge LI; Si-Cong WANG; Lei XU

摘要：BACKGROUND Fractional flow reserve (FFR) is the invasive gold standard for evaluating coronary arterial stenosis. Howe-ver, there have been a few non-invasive methods such as computational fluid dynamics FFR (CFD-FFR) with coronary CT an-giography (CCTA) images that can perform FFR assessment. This study aims to develop a new method based on the principle of static first-pass of CT perfusion imaging technique (SF-FFR) and evaluate the efficacy in direct comparisons between CFD-FFR and the invasive FFR. METHODS A total of 91 patients (105 coronary artery vessels) who were admitted from January 2015 to March 2019 were en-rolled in this study, retrospectively. All patients underwent CCTA and invasive FFR. 64 patients (75 coronary artery vessels) were successfully analyzed. The correlation and diagnostic performance of SF-FFR method on per-vessel basis were analyzed, using in-vasive FFR as the gold standard. As a comparison, we also evaluated the correlation and diagnostic performance of CFD-FFR. RESULTS The SF-FFR showed a good Pearson correlation (r = 0.70, P < 0.001) and intra-class correlation (r = 0.67, P < 0.001) with the gold standard. The Bland-Altman analysis showed that the average difference between the SF-FFR and invasive FFR was 0.03 (0.11–0.16); between CFD-FFR and invasive FFR was 0.04 (-0.10–0.19). Diagnostic accuracy and area under the ROC curve on a per-vessel level were 0.89, 0.94 for SF-FFR, and 0.87, 0.89 for CFD-FFR, respectively. The SF-FFR calculation time was about 2.5 s per case while CFD calculation was about 2 min on an Nvidia Tesla V100 graphic card. CONCLUSIONS The SF-FFR method is feasible and shows high correlation compared to the gold standard. This method could simplify the calculation procedure and save time compared to the CFD method.