Author + information
- Jai Parekh1,
- Saurabh Aggarwal1,
- Rohit Loomba2,
- Gaurav Aggarwal3,
- Ram Belbase1,
- Hemantha Koduri1,
- Brent Wilson4,
- Rohit Arora5 and
- Venkata M. Alla1
- 1Creighton University Medical Center, Omaha, Nebraska, United States
- 2Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- 3Armed Forces Medical College, Pune, Maharashtra, India
- 4University of Utah School of Medicine, Salt Lake City, Utah, United States
- 5Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, United States
Introduction: There has been a recent interest in fractional flow reserve measurements derived from computed tomography (CT-FFR) to evaluate the degree of coronary stenosis. Multiple studies have been performed comparing the diagnostic performance of CT-FFR to invasively derived (coronary angiography) fractional flow reserve (I-FFR).
We searched PubMed, Cochrane database and Google Scholar for terms “fractional flow reserve”, “computed tomography fractional flow reserve” and “CT-FFR”. Studies comparing CT-FFR to I-FFR were included in the analysis. Diagnostic performance was assessed by pooling the study results.
A total of 13 studies were included in the final analysis. The studies assessed a total of 1696 vessels in 1083 patients. In per-vessel analysis, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CT-FFR when compared with I-FFR were 89.1%, 71.7%, 69.2%, 89.9% and 79.9%. In per-patient analysis, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 89.9%, 71.9%, 69.4%, 89.9% and 79.1%.
CT-FFR has high sensitivity and negative predictive value when compared to I-FFR. However, improvements are needed to increase the specificity and positive predictive value.
IMAGING: FFR and Physiologic Lesion Assessment