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03-05-2023 | Angiography | Imaging Informatics and Artificial Intelligence

Diagnostic performance of angiography-derived fractional flow reserve analysis based on bifurcation fractal law for assessing hemodynamic significance of coronary stenosis

Authors: Hongbin Liang, Qiuxia Zhang, Yiting Gao, Guojun Chen, Yujia Bai, Yanan Zhang, Kai Cui, Qiancheng Wang, Shiping Cao, Yuqing Hou, Heye Zhang, Dhijnoo N. Ghista, Xiujian Liu, Jiancheng Xiu

Published in: European Radiology | Issue 10/2023

Abstract

Objectives

Blood flow into the side branch affects the calculation of coronary angiography-derived fractional flow reserve (FFR), called Angio-FFR. Neglecting or improperly compensating for the side branch flow may decrease the diagnostic accuracy of Angio-FFR. This study aims to evaluate the diagnostic accuracy of a novel Angio-FFR analysis that considers the side branch flow based on the bifurcation fractal law.

Methods

A one-dimensional reduced-order model based on the vessel segment was used to perform Angio-FFR analysis. The main epicardial coronary artery was divided into several segments according to the bifurcation nodes. Side branch flow was quantified using the bifurcation fractal law to correct the blood flow in each vessel segment. In order to verify the diagnostic performance of our Angio-FFR analysis, two other computational methods were taken as control groups: (i) FFR_s: FFR calculated by delineating the coronary artery tree to consider side branch flow, (ii) FFR_n: FFR calculated by just delineating the main epicardial coronary artery and neglecting the side branch flow.

Results

The analysis of 159 vessels from 119 patients showed that our Anio-FFR calculation method had comparable diagnostic accuracy to FFR_s and provided significantly higher diagnostic accuracy than that of FFR_n. In addition, using invasive FFR as a reference, the Pearson correlation coefficients of Angio-FFR and FFRs were 0.92 and 0.91, respectively, while that of FFR_n was only 0.85.

Conclusions

Our Angio-FFR analysis has demonstrated good diagnostic performance in assessing the hemodynamic significance of coronary stenosis by using the bifurcation fractal law to compensate for side branch flow.

Clinical relevance statement

Bifurcation fractal law can be used to compensate for side branch flow during the Angio-FFR calculation of the main epicardial vessel. Compensating for side branch flow can improve the ability of Angio-FFR to diagnose stenosis functional severity.

Key Points

• The bifurcation fractal law could accurately estimate the blood flow from the proximal main vessel into the main branch, thus compensating for the side branch flow.

• Angiography-derived FFR based on the bifurcation fractal law is feasible to evaluate the target diseased coronary artery without delineating the side branch.

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Title: Diagnostic performance of angiography-derived fractional flow reserve analysis based on bifurcation fractal law for assessing hemodynamic significance of coronary stenosis
Authors: Hongbin Liang
Qiuxia Zhang
Yiting Gao
Guojun Chen
Yujia Bai
Yanan Zhang
Kai Cui
Qiancheng Wang
Shiping Cao
Yuqing Hou
Heye Zhang
Dhijnoo N. Ghista
Xiujian Liu
Jiancheng Xiu
Publication date: 03-05-2023
Publisher: Springer Berlin Heidelberg
Keyword: Angiography
Published in: European Radiology / Issue 10/2023
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-023-09682-1

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Diagnostic performance of angiography-derived fractional flow reserve analysis based on bifurcation fractal law for assessing hemodynamic significance of coronary stenosis

Abstract

Objectives

Methods

Results

Conclusions

Clinical relevance statement

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Clinical relevance statement

Key Points

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