Combined Coronary CT-Angiography and TAVI Planning: Utility of CT-FFR in Patients with Morphologically Ruled-Out Obstructive Coronary Artery Disease
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. CT Acquisition
2.3. cCTA, ICA and QCA
2.4. Image Quality of cCTA and CAC
- 0 = nondiagnostic (excluded from this analysis, as CAD could not be excluded)
- 1 = diagnostic
- 2 = good
- 3 = excellent
2.5. CT-FFR
2.6. Statistical Analysis
3. Results
3.1. ML-Based CT-FFR
3.2. Analysis According to Image Quality and CAC
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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n | TP | TN | FP | FN | Sen. | Spe. | PPV | NPV | Acc. | |
---|---|---|---|---|---|---|---|---|---|---|
Patients cCTA | 109 | 0 | 107 | 0 | 2 | 0.0% | 100.0% | 98.2% | 98.2% | |
Patients CT-FFR | 2 | 31 | 76 | 0 | 100.0% | 29.0% | 2.6% | 100.0% | 30.3% | |
Difference Δ: patient level | 2 | −76 | 76 | −2 | +100.0% | −71.0% | +1.8% | −67.9% | ||
Vessels cCTA | 436 | 0 | 434 | 0 | 2 | 0.0% | 100.0% | 99.5% | 99.5% | |
Vessels CT-FFR | 0 | 308 | 126 | 2 | 0.0% | 71.0% | 0.0% | 99.4% | 70.6% | |
Difference Δ: vessel level | 0 | −126 | 126 | 0 | 0.0% | −29.0% | −0.2% | −28.9% | ||
Segments cCTA | 1456 | 0 | 1454 | 0 | 2 | 0.0% | 100.0% | 99.9% | 99.9% | |
Segments CT-FFR | 0 | 1268 | 186 | 2 | 0.0% | 87.2% | 0.0% | 99.8% | 87.1% | |
Difference Δ: segment level | 0 | −186 | 186 | 0 | 0.0% | −12.8% | 0.0% | −12.8% |
n | FP (%) | |
---|---|---|
Pat. | 109 | 76 (70) |
RCA | 109 | 46 (42) |
Seg. 1 | 109 | 0 (0) |
Seg. 2 | 108 | 2 (2) |
Seg. 3 | 101 | 13 (13) |
Seg. 4 | 76 | 30 (39) |
Seg. 16 | 80 | 26 (33) |
LM/Seg. 5 | 109 | 0 (0) |
LAD | 109 | 53 (49) |
Seg. 6 | 109 | 0 (0) |
Seg. 7 | 109 | 9 (8) |
Seg. 8 | 108 | 50 (46) |
Seg. 9 | 88 | 11 (13) |
Seg. 10 | 56 | 11 (20) |
Seg. 17 | 34 | 3 (9) |
CX | 109 | 27 (25) |
Seg. 11 | 109 | 1 (1) |
Seg. 12 | 88 | 7 (8) |
Seg. 13 | 90 | 6 (7) |
Seg. 14 | 58 | 7 (12) |
Seg. 15 | 11 | 4 (36) |
Seg. 18 | 13 | 6 (46) |
Variables | TN (n = 31) | FP (n = 76) | p | Correlation Coefficient | CI | p |
---|---|---|---|---|---|---|
Contrast opacification (HU) | 510.9 ± 125.8 | 487.3 ± 165.2 | 0.43 | 0.07 | −0.12, 0.26 | 0.48 |
CNR | 12.33 ± 3.67 | 12.38 ± 4.19 | 0.94 | −0.007 | −0.20, 0.18 | 0.95 |
Image quality score | 2 (1) | 2 (1) | 0.74 | 0.03 | −0.15, 0.21 | 0.73 |
CACPatient | 343.4 (584.1) | 189.6 (538.1) | 0.10 | 0.16 | −0.03, 0.34 | 0.10 |
CACRCA | 47.2 (225.5) | 22.3 (80.1) | 0.39 | 0.08 | −0.11, 0.27 | 0.39 |
CACLAD | 42.6 (183.8) | 118.0 (315.1) | 0.04 | −0.20 | −0.38, −0.01 | 0.03 |
CACCX | 9.0 (80.4) | 9.6 (85.9) | 0.91 | −0.01 | −0.21, 0.19 | 0.91 |
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Gohmann, R.F.; Seitz, P.; Pawelka, K.; Majunke, N.; Schug, A.; Heiser, L.; Renatus, K.; Desch, S.; Lauten, P.; Holzhey, D.; et al. Combined Coronary CT-Angiography and TAVI Planning: Utility of CT-FFR in Patients with Morphologically Ruled-Out Obstructive Coronary Artery Disease. J. Clin. Med. 2022, 11, 1331. https://doi.org/10.3390/jcm11051331
Gohmann RF, Seitz P, Pawelka K, Majunke N, Schug A, Heiser L, Renatus K, Desch S, Lauten P, Holzhey D, et al. Combined Coronary CT-Angiography and TAVI Planning: Utility of CT-FFR in Patients with Morphologically Ruled-Out Obstructive Coronary Artery Disease. Journal of Clinical Medicine. 2022; 11(5):1331. https://doi.org/10.3390/jcm11051331
Chicago/Turabian StyleGohmann, Robin Fabian, Patrick Seitz, Konrad Pawelka, Nicolas Majunke, Adrian Schug, Linda Heiser, Katharina Renatus, Steffen Desch, Philipp Lauten, David Holzhey, and et al. 2022. "Combined Coronary CT-Angiography and TAVI Planning: Utility of CT-FFR in Patients with Morphologically Ruled-Out Obstructive Coronary Artery Disease" Journal of Clinical Medicine 11, no. 5: 1331. https://doi.org/10.3390/jcm11051331