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  • Baumann, StefanMed Univ South Carolina, SC 29425 USA; Univ Med Ctr Mannheim, Germany (author)

Gender differences in the diagnostic performance of machine learning coronary CT angiography-derived fractional flow reserve -results from the MACHINE registry

  • Article/chapterEnglish2019

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  • ELSEVIER IRELAND LTD,2019
  • printrdacarrier

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  • LIBRIS-ID:oai:DiVA.org:liu-161001
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-161001URI
  • https://doi.org/10.1016/j.ejrad.2019.108657DOI

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  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Purpose: This study investigated the impact of gender differences on the diagnostic performance of machine-learning based coronary CT angiography (cCTA)-derived fractional flow reserve (CT-FFR mL ) for the detection of lesion-specific ischemia. Method: Five centers enrolled 351 patients (73.5% male) with 525 vessels in the MACHINE (Machine leArning Based CT angiograpHy derIved FFR: a Multi-ceNtEr) registry. CT-FFRML and invasive FFR amp;lt;= 0.80 were considered hemodynamically significant, whereas cCTA luminal stenosis amp;gt;= 50% was considered obstructive. The diagnostic performance to assess lesion-specific ischemia in both men and women was assessed on a per-vessel basis. Results: In total, 398 vessels in men and 127 vessels in women were included. Compared to invasive FFR, CT-FFRML reached a sensitivity, specificity, positive predictive value, and negative predictive value of 78% (95%CI 72-84), 79% (95%CI 73-84), 75% (95%CI 69-79), and 82% (95%CI: 76-86) in men vs. 75% (95%CI 58-88), 81 (95%CI 72-89), 61% (95%CI 50-72) and 89% (95%CI 82-94) in women, respectively. CT-FFRML showed no statistically significant difference in the area under the receiver-operating characteristic curve (AUC) in men vs. women (AUC: 0.83 [95%CI 0.79-0.87] vs. 0.83 [95%CI 0.75-0.89], p = 0.89). CT-FFRML was not superior to cCTA alone [AUC: 0.83 (95%CI: 0.75-0.89) vs. 0.74 (95%CI: 0.65-0.81), p = 0.12] in women, but showed a statistically significant improvement in men [0.83 (95%CI: 0.79-0.87) vs. 0.76 (95%CI: 0.71-0.80), p = 0.007]. Conclusions: Machine-learning based CT-FFR performs equally in men and women with superior diagnostic performance over cCTA alone for the detection of lesion-specific ischemia.

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  • Renker, MatthiasMed Univ South Carolina, SC 29425 USA; Kerckhoff Heart and Thorax Ctr, Germany (author)
  • Schoepf, U. JosephMed Univ South Carolina, SC 29425 USA; Med Univ South Carolina, SC 29425 USA (author)
  • De Cecco, Carlo N.Med Univ South Carolina, SC 29425 USA (author)
  • Coenen, AdriaanErasmus Univ, Netherlands; Erasmus Univ, Netherlands (author)
  • de Geer, JakobLinköpings universitet,Avdelningen för radiologiska vetenskaper,Medicinska fakulteten,Centrum för medicinsk bildvetenskap och visualisering, CMIV,Region Östergötland, Röntgenkliniken i Linköping(Swepub:liu)jakde64 (author)
  • Kruk, MariuszInst Cardiol, Poland (author)
  • Kim, Young-HakUniv Ulsan, South Korea (author)
  • Albrecht, Moritz H.Med Univ South Carolina, SC 29425 USA; Univ Hosp Frankfurt, Germany (author)
  • Duguay, Taylor M.Med Univ South Carolina, SC 29425 USA (author)
  • Jacobs, Brian E.Med Univ South Carolina, SC 29425 USA (author)
  • Bayer, Richard R.Med Univ South Carolina, SC 29425 USA; Med Univ South Carolina, SC 29425 USA (author)
  • Litwin, Sheldon E.Med Univ South Carolina, SC 29425 USA; Med Univ South Carolina, SC 29425 USA (author)
  • Weiss, ChristelHeidelberg Univ, Germany (author)
  • Akin, IbrahimUniv Med Ctr Mannheim, Germany (author)
  • Borggrefe, MartinUniv Med Ctr Mannheim, Germany (author)
  • Yang, Dong HyunUniv Ulsan, South Korea (author)
  • Kepka, CezaryInst Cardiol, Poland (author)
  • Persson, AndersLinköpings universitet,Avdelningen för radiologiska vetenskaper,Medicinska fakulteten,Centrum för medicinsk bildvetenskap och visualisering, CMIV,Region Östergötland, Röntgenkliniken i Linköping(Swepub:liu)andpe75 (author)
  • Nieman, KoenErasmus Univ, Netherlands; Erasmus Univ, Netherlands; Stanford Univ, CA 94305 USA (author)
  • Tesche, ChristianMed Univ South Carolina, SC 29425 USA; Heart Ctr Munich Bogenhausen, Germany; Ludwig Maximilians Univ Munchen, Germany (author)
  • Med Univ South Carolina, SC 29425 USA; Univ Med Ctr Mannheim, GermanyMed Univ South Carolina, SC 29425 USA; Kerckhoff Heart and Thorax Ctr, Germany (creator_code:org_t)

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  • In:European Journal of Radiology: ELSEVIER IRELAND LTD1190720-048X1872-7727

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