Imperial College London
Alternate

Emeritus ProfessorRichardUnderwood

Faculty of Medicine, National Heart & Lung Institute

Emeritus Professor of Cardiac Imaging
 
 
 
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Contact

 

+44 (0)20 7351 8811srunderwood

 
 
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Location

 

2.30Britten WingRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Driessen:2019:10.1016/j.jacc.2018.10.056,
author = {Driessen, RS and Danad, I and Stuijfzand, WJ and Raijmakers, PG and Schumacher, SP and van, Diemen PA and Leipsic, JA and Knuuti, J and Underwood, SR and van, de Ven PM and van, Rossum AC and Taylor, CA and Knaapen, P},
doi = {10.1016/j.jacc.2018.10.056},
journal = {Journal of the American College of Cardiology},
pages = {161--173},
title = {Comparison of coronary computed tomography angiography, fractional flow reserve, and perfusion imaging for ischemia diagnosis},
url = {http://dx.doi.org/10.1016/j.jacc.2018.10.056},
volume = {73},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundFractional flow reserve (FFR) computation from coronary computed tomography angiography (CTA) datasets (FFRCT) has emerged as a promising noninvasive test to assess hemodynamic severity of coronary artery disease (CAD), but has not yet been compared with traditional functional imaging.ObjectivesThe purpose of this study was to evaluate the diagnostic performance of FFRCT and compare it with coronary CTA, single-photon emission computed tomography (SPECT), and positron emission tomography (PET) for ischemia diagnosis.MethodsThis subanalysis involved 208 prospectively included patients with suspected stable CAD, who underwent 256-slice coronary CTA, 99mTc-tetrofosmin SPECT, [15O]H2O PET, and routine 3-vessel invasive FFR measurements. FFRCT values were retrospectively derived from the coronary CTA images. Images from each modality were interpreted by core laboratories, and their diagnostic performances were compared using invasively measured FFR ≤0.80 as the reference standard.ResultsIn total, 505 of 612 (83%) vessels could be evaluated with FFRCT. FFRCT showed a diagnostic accuracy, sensitivity, and specificity of 87%, 90%, and 86% on a per-vessel basis and 78%, 96%, and 63% on a per-patient basis, respectively. Area under the receiver-operating characteristic curve (AUC) for identification of ischemia-causing lesions was significantly greater for FFRCT (0.94 and 0.92) in comparison with coronary CTA (0.83 and 0.81; p < 0.01 for both) and SPECT (0.70 and 0.75; p < 0.01 for both), on a per-vessel and -patient level, respectively. FFRCT also outperformed PET on a per-vessel basis (AUC 0.87; p < 0.01), but not on a per-patient basis (AUC 0.91; p = 0.56). In the intention-to-diagnose analysis, PET showed the highest per-patient and -vessel AUC followed by FFRCT (0.86 vs. 0.83; p = 0.157; and 0.90 vs. 0.79; p = 0.005, respectively).ConclusionsIn this study, FFRCT showed higher diagnostic performance than standard coronary CTA, SPECT, and PET for vess
AU  - Driessen,RS
AU  - Danad,I
AU  - Stuijfzand,WJ
AU  - Raijmakers,PG
AU  - Schumacher,SP
AU  - van,Diemen PA
AU  - Leipsic,JA
AU  - Knuuti,J
AU  - Underwood,SR
AU  - van,de Ven PM
AU  - van,Rossum AC
AU  - Taylor,CA
AU  - Knaapen,P
DO  - 10.1016/j.jacc.2018.10.056
EP  - 173
PY  - 2019///
SN  - 0735-1097
SP  - 161
TI  - Comparison of coronary computed tomography angiography, fractional flow reserve, and perfusion imaging for ischemia diagnosis
T2  - Journal of the American College of Cardiology
UR  - http://dx.doi.org/10.1016/j.jacc.2018.10.056
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000455676500007&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/72025
VL  - 73
ER  -
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