Diagnostic Accuracy of a Machine-Learning Approach to Coronary Computed Tomographic Angiography-Based Fractional Flow Reserve: Result From the MACHINE Consortium.

Journal: Circulation. Cardiovascular imaging
Published Date: Jun 1, 2018

Abstract

BACKGROUND: Coronary computed tomographic angiography (CTA) is a reliable modality to detect coronary artery disease. However, CTA generally overestimates stenosis severity compared with invasive angiography, and angiographic stenosis does not necessarily imply hemodynamic relevance when fractional flow reserve (FFR) is used as reference. CTA-based FFR (CT-FFR), using computational fluid dynamics (CFD), improves the correlation with invasive FFR results but is computationally demanding. More recently, a new machine-learning (ML) CT-FFR algorithm has been developed based on a deep learning model, which can be performed on a regular workstation. In this large multicenter cohort, the diagnostic performance ML-based CT-FFR was compared with CTA and CFD-based CT-FFR for detection of functionally obstructive coronary artery disease.

Authors

  • Adriaan Coenen
    Department of Cardiology (A.C., M.L.L., J.D., K.N.) a.coenen@erasmusmc.nl.
  • Young-Hak Kim
    Asan Medical Center, Seoul, Republic of Korea.
  • Mariusz Kruk
    Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Coronary Disease and Structural Heart Diseases Department, Institute of Cardiology, Warsaw, Poland (M.K., C.K.).
  • Christian Tesche
    Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29425-2260 (S.S.M., D.M., M.v.A., C.N.D.C., R.R.B., C.T., A.V.S., A.M.F., B.E.J., L.P.G., U.J.S.); Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany (S.S.M., T.J.V.); Stanford University School of Medicine, Department of Radiology, Stanford, Calif (D.M.); Division of Cardiothoracic Imaging, Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (C.N.D.C.); Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC (R.R.B.); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany (C.T.); Department of Cardiology, Munich University Clinic, Ludwig-Maximilians-University, Munich, Germany (C.T.); Siemens Medical Solutions USA, Malvern, Pa (P.S.); and Department of Emergency Medicine, Medical University of South Carolina, Charleston, SC (A.J.M.).
  • Jakob De Geer
    Department of Radiology and Department of Medical and Health Sciences, Center for Medical Image Science and Visualization, Linköping University, Sweden (J.D.G., A.P.).
  • Akira Kurata
    Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
  • Marisa L Lubbers
    Department of Cardiology (A.C., M.L.L., J.D., K.N.).
  • Joost Daemen
    Department of Cardiology (A.C., M.L.L., J.D., K.N.).
  • Lucian Itu
    Siemens Corporate Technology, Siemens SRL, Brasov, Romania; Transilvania University of Brasov, Brasov, Romania.
  • Saikiran Rapaka
    From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (C.T., C.N.D.C., S.B., M.R., T.W.M., T.M.D., R.R.B., U.J.S.), and Division of Cardiology, Department of Medicine (R.R.B., D.H.S., U.J.S.), Medical University of South Carolina, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29425-2260; Department of Computed Tomography-Research & Development, Siemens Healthcare GmbH, Forchheim, Germany (K.L.G., C.C., C.S., M.S.); Department of Corporate Technology, Siemens SRL, Brasov, Romania (L.M.I.); and Department of Medical Imaging Technologies, Siemens Healthcare, Princeton, NJ (S.R., P.S.).
  • Puneet Sharma
    Digital Technologies and Innovation, Siemens Healthineers, Princeton, NJ, United States.
  • Chris Schwemmer
    From the Division of Cardiovascular Imaging, Department of Radiology and Radiological Science (C.T., C.N.D.C., S.B., M.R., T.W.M., T.M.D., R.R.B., U.J.S.), and Division of Cardiology, Department of Medicine (R.R.B., D.H.S., U.J.S.), Medical University of South Carolina, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29425-2260; Department of Computed Tomography-Research & Development, Siemens Healthcare GmbH, Forchheim, Germany (K.L.G., C.C., C.S., M.S.); Department of Corporate Technology, Siemens SRL, Brasov, Romania (L.M.I.); and Department of Medical Imaging Technologies, Siemens Healthcare, Princeton, NJ (S.R., P.S.).
  • Anders Persson
    Department of Radiology and Department of Medical and Health Sciences, Center for Medical Image Science and Visualization, Linköping University, Sweden (J.D.G., A.P.).
  • U Joseph Schoepf
    Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29425-2260 (S.S.M., D.M., M.v.A., C.N.D.C., R.R.B., C.T., A.V.S., A.M.F., B.E.J., L.P.G., U.J.S.); Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany (S.S.M., T.J.V.); Stanford University School of Medicine, Department of Radiology, Stanford, Calif (D.M.); Division of Cardiothoracic Imaging, Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (C.N.D.C.); Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC (R.R.B.); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany (C.T.); Department of Cardiology, Munich University Clinic, Ludwig-Maximilians-University, Munich, Germany (C.T.); Siemens Medical Solutions USA, Malvern, Pa (P.S.); and Department of Emergency Medicine, Medical University of South Carolina, Charleston, SC (A.J.M.).
  • Cezary Kepka
    Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Coronary Disease and Structural Heart Diseases Department, Institute of Cardiology, Warsaw, Poland (M.K., C.K.).
  • Dong Hyun Yang
    Department of Radiology (D.H.Y.).
  • Koen Nieman
    Department of Cardiology (A.C., M.L.L., J.D., K.N.).

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