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  • Tesche, ChristianMed Univ South Carolina, Dept Radiol & Radiol Sci, Div Cardiovasc Imaging, Charleston, SC 29425 USA; Heart Ctr Munich Bogenhausen, Dept Cardiol & Intens Care Med, Munich, Germany; Ludwig Maximilians Univ Munchen, Munich Univ Clin, Dept Cardiol, Munich, Germany (author)

Influence of Coronary Calcium on Diagnostic Performance of Machine Learning CT-FFR Results From MACHINE Registry

  • Article/chapterEnglish2020

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  • ELSEVIER SCIENCE INC,2020
  • printrdacarrier

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  • LIBRIS-ID:oai:DiVA.org:liu-167489
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-167489URI
  • https://doi.org/10.1016/j.jcmg.2019.06.027DOI

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  • Language:English
  • Summary in:English

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

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  • OBJECTIVESThis study was conducted to investigate the influence of coronary artery calcium (CAC) score on the diagnostic performance of machine-learning-based coronary computed tomography (CT) angiography (cCTA)-derived fractional flow reserve (CT-FFR).BACKGROUNDCT-FFR is used reliably to detect lesion-specific ischemia. Novel CT-FFR algorithms using machine-learning artificial intelligence techniques perform fast and require less complex computational fluid dynamics. Yet, influence of CAC score on diagnostic performance of the machine-learning approach has not been investigated.METHODSA total of 482 vessels from 314 patients (age 62.3 +/- 9.3 years, 77% male) who underwent cCTA followed by invasive FFR were investigated from the MACHINE (Machine Learning based CT Angiography derived FFR: a Multi-center Registry) registry data. CAC scores were quantified using the Agatston convention. The diagnostic performance of CT-FFR to detect lesion-specific ischemia was assessed across all Agatston score categories (CAC 0, >0 to <100, 100 to <400, and >=$400) on a per-vessel level with invasive FFR as the reference standard.RESULTSThe diagnostic accuracy of CT-FFR versus invasive FFR was superior to cCTA alone on a per-vessel level (78% vs. 60%) and per patient level (83% vs. 73%) across all Agatston score categories. No statistically significant differences in the diagnostic accuracy, sensitivity, or specificity of CT-FFR were observed across the categories. CT-FFR showed good discriminatory power in vessels with high Agatston scores (CAC >= 400) and high performance in low-to-intermediate Agatston scores (CAC >0 to <400) with a statistically significant difference in the area under the receiver-operating characteristic curve (AUC) (AUC: 0.71 [95% confidence interval (CI): 0.57 to 0.85] vs. 0.85 [95% CI: 0.82 to 0.89], p = 0.04). CT-FFR showed superior diagnostic value over cCTA in vessels with high Agatston scores (CAC >= 400: AUC 0.71 vs. 0.55, p = 0.04) and low-to-intermediate Agatston scores (CAC >0 to <400: AUC 0.86 vs. 0.63, p < 0.001).CONCLUSIONSMachine-learning-based CT-FFR showed superior diagnostic performance over cCTA alone in CAC with a significant difference in the performance of CT-FFR as calcium burden/Agatston calcium score increased. (Machine Learning Based CT Angiography Derived FFR: a Multicenter, Registry [MACHINE] NCT02805621). (C) 2020 by the American College of Cardiology Foundation.

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  • Otani, KatharinaSiemens Healthcare KK, Adv Therapies Innovat Dept, Tokyo, Japan (author)
  • De Cecco, Carlo N.Med Univ South Carolina, Dept Radiol & Radiol Sci, Div Cardiovasc Imaging, Charleston, SC 29425 USA (author)
  • Coenen, AdriaanErasmus MC, Dept Cardiol, Rotterdam, Netherlands; Erasmus MC, Dept Radiol, Rotterdam, Netherlands (author)
  • De Geer, Jakob,1970-Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Centrum för medicinsk bildvetenskap och visualisering, CMIV,Region Östergötland, Röntgenkliniken i Linköping(Swepub:liu)jakde64 (author)
  • Kruk, MariuszInst Cardiol, Invas Cardiol & Angiol Dept, Coronary Dis & Struct Heart Dis Dept, Warsaw, Poland (author)
  • Kim, Young-HakUniv Ulsan, Coll Med, Asan Med Ctr, Dept Cardiol,Heart Inst, Seoul, South Korea (author)
  • Albrecht, Moritz H.Med Univ South Carolina, Dept Radiol & Radiol Sci, Div Cardiovasc Imaging, Charleston, SC 29425 USA; Univ Hosp Frankfurt, Dept Diagnost & Intervent Radiol, Frankfurt, Germany (author)
  • Baumann, StefanMed Univ South Carolina, Dept Radiol & Radiol Sci, Div Cardiovasc Imaging, Charleston, SC 29425 USA; Heidelberg Univ, Univ Med Ctr Mannheim UMM, Fac Med Mannheim, Dept Med 1, Mannheim, Germany (author)
  • Renker, MatthiasMed Univ South Carolina, Dept Radiol & Radiol Sci, Div Cardiovasc Imaging, Charleston, SC 29425 USA; Kerckhoff Heart Ctr, Dept Cardiol, Bad Nauheim, Germany (author)
  • Bayer, Richard R.Med Univ South Carolina, Dept Radiol & Radiol Sci, Div Cardiovasc Imaging, Charleston, SC 29425 USA; Med Univ South Carolina, Dept Med, Div Cardiol, Charleston, SC 29425 USA (author)
  • Duguay, Taylor M.Med Univ South Carolina, Dept Radiol & Radiol Sci, Div Cardiovasc Imaging, Charleston, SC 29425 USA (author)
  • Litwin, Sheldon E.Med Univ South Carolina, Dept Radiol & Radiol Sci, Div Cardiovasc Imaging, Charleston, SC 29425 USA; Med Univ South Carolina, Dept Med, Div Cardiol, Charleston, SC 29425 USA (author)
  • Varga-Szemes, AkosMed Univ South Carolina, Dept Radiol & Radiol Sci, Div Cardiovasc Imaging, Charleston, SC 29425 USA (author)
  • Steinberg, Daniel H.Med Univ South Carolina, Dept Med, Div Cardiol, Charleston, SC 29425 USA (author)
  • Yang, Dong HyunUniv Ulsan, Coll Med, Asan Med Ctr, Dept Radiol, Seoul, South Korea (author)
  • Kepka, CezaryInst Cardiol, Invas Cardiol & Angiol Dept, Coronary Dis & Struct Heart Dis Dept, Warsaw, Poland (author)
  • Persson, Anders,1953-Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Centrum för medicinsk bildvetenskap och visualisering, CMIV,Region Östergötland, Röntgenkliniken i Linköping(Swepub:liu)andpe75 (author)
  • Nieman, KoenErasmus MC, Dept Cardiol, Rotterdam, Netherlands; Erasmus MC, Dept Radiol, Rotterdam, Netherlands; Stanford Univ, Sch Med, Cardiovasc Inst, Stanford, CA 94305 USA (author)
  • Schoepf, U. JosephMed Univ South Carolina, Dept Radiol & Radiol Sci, Div Cardiovasc Imaging, Charleston, SC 29425 USA; Med Univ South Carolina, Dept Med, Div Cardiol, Charleston, SC 29425 USA (author)
  • Med Univ South Carolina, Dept Radiol & Radiol Sci, Div Cardiovasc Imaging, Charleston, SC 29425 USA; Heart Ctr Munich Bogenhausen, Dept Cardiol & Intens Care Med, Munich, Germany; Ludwig Maximilians Univ Munchen, Munich Univ Clin, Dept Cardiol, Munich, GermanySiemens Healthcare KK, Adv Therapies Innovat Dept, Tokyo, Japan (creator_code:org_t)

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  • In:JACC Cardiovascular Imaging: ELSEVIER SCIENCE INC13:3, s. 760-7701936-878X1876-7591

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