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Coronary CT angiography-based FFR with ultrahigh-resolution photon-counting detector CT: Intra-individual comparison to energy-integrating detector CT.

Author information

Affiliations

  • 1. Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, United States; Heart and Vascular Centre, Semmelweis University, 68 Varosmajor Street, Budapest 1122, Hungary.
      Authors
    • Vecsey-Nagy M 1
    (1 author)
  • 2. Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, United States; Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome - Sant'Andrea University Hospital, 1035-1039 Via di Grottarossa, Rome 00189, Italy.
      Authors
    • Tremamunno G 2
    (1 author)
  • 3. Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, United States.
      Authors
    • Schoepf UJ 3
    • Spruill Suranyi P 3
    • Varga-Szemes A 3
    (3 authors)
  • 4. Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, United States; Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, 60 Via Olgettina, Milan 20132, Italy.
      Authors
    • Gnasso C 4
    (1 author)
  • 5. Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, United States; MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Center, Semmelweis University, 2 Koranyi Sandor Street, Budapest 1083, Hungary.
      Authors
    • Zsarnóczay E 5
    (1 author)
    • Show all (13)

European Journal of Radiology, 19 Oct 2024, 181:111797
https://doi.org/10.1016/j.ejrad.2024.111797 PMID: 39454427 

Abstract 

Purpose

To evaluate the feasibility of CT angiography-derived fractional flow reserve (CT-FFR) calculations on ultrahigh-resolution (UHR) photon-counting detector (PCD)-CT series and to intra-individually compare the results with energy-integrating (EID)-CT measurements.

Method

Prospective patients with calcified plaques detected on EID-CT between April 1st, 2023 and January 31st, 2024 were recruited for a UHR CCTA on PCD-CT within 30 days. PCD-CT was performed using the same or a lower CT dose index and an equivalent volume of contrast media. An on-site machine learning algorithm was used to obtain CT-FFR values on a per-vessel and per-patient basis. For all analyses, CT-FFR values ≤ 0.80 were deemed to be hemodynamically significant.

Results

A total of 34 patients (age: 67.3 ± 6.6 years, 7 women [20.6 %]) were included. Excellent inter-scanner agreement was noted for CT-FFR values in the per-vessel (ICC: 0.93 [0.90-0.95]) and per-patient (ICC: 0.94 [0.88-0.97]) analysis. PCD-CT-derived CT-FFR values proved to be higher compared to EID-CT values on both vessel (0.58 ± 0.23 vs. 0.55 ± 0.23, p < 0.001) and patient levels (0.73 ± 0.23 vs. 0.70 ± 0.22, p < 0.001). Two patients (5.9 %) with hemodynamically significant lesions on EID-CT were reclassified as non-significant on PCD-CT. All remaining participants were classified into the same category with both scanner systems.

Conclusions

While UHR CT-FFR values demonstrate excellent agreement with EID-CT measurements, PCD-CT produces higher CT-FFR values that could contribute to a reclassification of hemodynamic significance.

Full text links 

Read article at publisher's site: https://doi.org/10.1016/j.ejrad.2024.111797

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Funding 

Funders who supported this work.

Magyar Tudományos Akadémia

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