Journal ArticleDOI
Diagnostic accuracy of quantitative flow ratio for assessment of coronary stenosis significance from a single angiographic view: A novel method based on bifurcation fractal law
Reads0
Chats0
TLDR
In this article, an artificial intelligence algorithm was proposed for automatic delineation of lumen contours of major epicardial coronary arteries including their side branches, and a stepdown reference diameter function was reconstructed based on the Murray bifurcation fractal law and used for QFR computation.Abstract:
OBJECTIVES We aimed to evaluate the diagnostic accuracy of computation of fractional flow reserve (FFR) from a single angiographic view in patients with intermediate coronary stenosis. BACKGROUND Computation of quantitative flow ratio (QFR) from a single angiographic view might increase the feasibility of routine use of computational FFR. In addition, current QFR solutions assume a linear tapering of the reference vessel size, which might decrease the diagnostic accuracy in the presence of the physiologically significant bifurcation lesions. METHODS An artificial intelligence algorithm was proposed for automatic delineation of lumen contours of major epicardial coronary arteries including their side branches. A step-down reference diameter function was reconstructed based on the Murray bifurcation fractal law and used for QFR computation. Validation of this Murray law-based QFR (μQFR) was performed on the FAVOR II China study population. The μQFR was computed separately in two angiographic projections, starting with the one with optimal angiographic image quality. Hemodynamically significant coronary stenosis was defined by pressure wire-derived FFR ≤0.80. RESULTS The μQFR was successfully computed in all 330 vessels of 306 patients. There was excellent correlation (r = 0.90, p < .001) and agreement (mean difference = 0.00 ± 0.05, p = .378) between μQFR and FFR. The vessel-level diagnostic accuracy for μQFR to identify hemodynamically significant stenosis was 93.0% (95% CI: 90.3 to 95.8%), with sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of 87.5% (95% CI: 80.2 to 92.8%), 96.2% (95% CI: 92.6 to 98.3%), 92.9% (95% CI: 86.5 to 96.9%), 93.1% (95% CI: 88.9 to 96.1%), 23.0 (95% CI: 11.6 to 45.5), 0.13 (95% CI: 0.08 to 0.20), respectively. Use of suboptimal angiographic image view slightly decreased the diagnostic accuracy of μQFR (AUC = 0.97 versus 0.92, difference = 0.05, p < .001). Intra- and inter-observer variability for μQFR computation was 0.00 ± 0.03, and 0.00 ± 0.03, respectively. Average analysis time for μQFR was 67 ± 22 s. CONCLUSIONS Computation of μQFR from a single angiographic view has high feasibility and excellent diagnostic accuracy in identifying hemodynamically significant coronary stenosis. The short analysis time and good reproducibility of μQFR bear potential of wider adoption of physiological assessment in the catheterization laboratory.read more
Citations
More filters
Journal ArticleDOI
Angiographic quantitative flow ratio-guided coronary intervention (FAVOR III China): a multicentre, randomised, sham-controlled trial.
Bo Xu,Shengxian Tu,Lei Song,Zening Jin,Bo Yu,Guosheng Fu,Yujie Zhou,Jian-an Wang,Yundai Chen,Jun Pu,Lianglong Chen,Xinkai Qu,Junqing Yang,Xuebo Liu,Lijun Guo,Chengxing Shen,Yao-Jun Zhang,Qi Zhang,Hongwei Pan,Xiaogang Fu,Jian K. Liu,Yanyan Zhao,Javier Escaned,Yang Wang,William F Fearon,Kefei Dou,Ajay J. Kirtane,Yongjian Wu,Patrick W. Serruys,Weixian Yang,William Wijns,Changdong Guan,Martin B. Leon,Shubin Qiao,Gregg W. Stone +34 more
TL;DR: The FAVOR III China trial as mentioned in this paper showed that a QFR-guided strategy of lesion selection for percutaneous coronary intervention improved 1-year clinical outcomes compared with standard angiography guidance.
Journal ArticleDOI
Definitions and Standardized Endpoints for Treatment of Coronary Bifurcations.
Mattia Lunardi,Yves Louvard,Thierry Lefèvre,Goran Stankovic,Francesco Burzotta,Ghassan S. Kassab,Jens Flensted Lassen,Olivier Darremont,Scot Garg,Bon-Kwon Koo,Niels Ramsing Holm,Thomas E. Johnson,Manuel Pan,Yiannis S. Chatzizisis,Adrian P. Banning,Alaide Chieffo,Dariusz Dudek,David Hildick-Smith,Jérôme Garot,Timothy D. Henry,George Dangas,Gregg W. Stone,Mitchell W. Krucoff,Donald E. Cutlip,Roxana Mehran,William Wijns,Faisal Sharif,Patrick W. Serruys,Yoshinobu Onuma +28 more
TL;DR: The Bif-ARC project as discussed by the authors is a collaborative effort between academic research organizations and the most renowned interventional cardiology societies focused on bifurcation lesions in Europe, the United States, and Asia.
Journal ArticleDOI
Reproducibility of quantitative flow ratio: the QREP study
TL;DR: In this article , the reproducibility of quantitative flow ratio (QFR) computed from the same angiograms as assessed by multiple observers from different, international sites was evaluated.
Journal ArticleDOI
Percutaneous Coronary Revascularization: JACC Historical Breakthroughs in Perspective
Patrick W. Serruys,Patrick W. Serruys,Masafumi Ono,Scot Garg,Hironori Hara,Hideyuki Kawashima,Giulio Pompilio,Daniele Andreini,David R. Holmes,Yoshinobu Onuma,Spencer B. King +10 more
TL;DR: In this article, percutaneous coronary intervention and coronary artery bypass graft surgery were compared in patients with multivessel disease and unprotected left-main stem coronary artery disease, and the relative merits of each technique were established with regard to the type of ischemic syndrome, the coronary anatomy, and patient's overall comorbidity.
Journal ArticleDOI
Angiographic Quantitative Flow Ratio-Guided Coronary Intervention: Two-Year Outcomes of the FAVOR III China Trial
Lei Song,Bo Xu,Shengxian Tu,Changdong Guan,Zening Jin,Bo Yu,Guosheng Fu,Yujie Zhou,Jian-an Wang,Yundai Chen,Jun Pu,Lianglong Chen,Xin-Kai Qu,Junqing Yang,Xuebo Liu,Lijun Guo,Chengxing Shen,Yaojun Zhang,Q. Zhang,Hongwei Pan,Rui Zhang,Jian Liu,Yanyan Zhao,Yang Wang,Kefei Dou,Ajay J. Kirtane,Yongjian Wu,William Wijns,Weixian Yang,Martin B. Leon,Shu-zhen Qiao,Gregg W. Stone +31 more
TL;DR: In this paper , a comparison of quantitative flow ratio guided and standard angiography guided percutaneous intervention in patients with Coronary Artery disease (CARD) was conducted.
References
More filters
Book ChapterDOI
U-Net: Convolutional Networks for Biomedical Image Segmentation
TL;DR: Neber et al. as discussed by the authors proposed a network and training strategy that relies on the strong use of data augmentation to use the available annotated samples more efficiently, which can be trained end-to-end from very few images and outperforms the prior best method (a sliding-window convolutional network) on the ISBI challenge for segmentation of neuronal structures in electron microscopic stacks.
Journal ArticleDOI
2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes.
Juhani Knuuti,William Wijns,Antti Saraste,Davide Capodanno,Emanuele Barbato,Christian Funck-Brentano,Eva Prescott,Robert F. Storey,Christi Deaton,Thomas Cuisset,Stefan Agewall,Kenneth Dickstein,Thor Edvardsen,Javier Escaned,Bernard J. Gersh,Pavel Svitil,Martine Gilard,David Hasdai,Robert Hatala,Felix Mahfoud,Josep Masip,Claudio Muneretto,Marco Valgimigli,Stephan Achenbach,Jeroen J. Bax +24 more
TL;DR: In this article, the authors present guidelines for the management of patients with coronary artery disease (CAD), which is a pathological process characterized by atherosclerotic plaque accumulation in the epicardial arteries.
Journal ArticleDOI
The Physiological Principle of Minimum Work: I. The Vascular System and the Cost of Blood Volume.
Journal ArticleDOI
Diagnostic Accuracy of Fast Computational Approaches to Derive Fractional Flow Reserve From Diagnostic Coronary Angiography : The International Multicenter FAVOR Pilot Study
Shengxian Tu,Jelmer Westra,Junqing Yang,Clemens von Birgelen,Angela Ferrara,Mariano Pellicano,Holger Nef,Matteo Tebaldi,Yoshinobu Murasato,Alexandra J. Lansky,Emanuele Barbato,Liefke C. van der Heijden,Johan H. C. Reiber,Niels Ramsing Holm,William Wijns +14 more
TL;DR: The QFR computation improved the diagnostic accuracy of 3-dimensional quantitative coronary angiography-based identification of stenosis significance and bears the potential of a wider adoption of FFR-based lesion assessment through a reduction in procedure time, risk, and costs.
Journal ArticleDOI
Physiologic Assessment of Jailed Side Branch Lesions Using Fractional Flow Reserve
Bon-Kwon Koo,Hyun-Jai Kang,Tae-Jin Youn,In-Ho Chae,Dong-Joo Choi,Hyo-Soo Kim,Dae-Won Sohn,Byung Hee Oh,Myoung-Mook Lee,Young-Bae Park,Yun-Shik Choi,Seung-Jae Tahk +11 more
TL;DR: The FFR measurement in jailed side branch lesions is both safe and feasible and compared with the stenosis severity assessed by quantitative coronary angiography, which suggests that most of these lesions do not have functional significance.