Department of Radiology, the Affiliated Hospital of Inner Mongolia Medical University, No.1 Tongdao North Street, Hohhot, Inner Mongolia, 010050, China.
Department of Basic Medicine College, Inner Mongolia Medical University, No.5 Tongdao North Street, Hohhot, Inner Mongolia, 010059, China.
BMC Med Imaging. 2024 Oct 24;24(1):288. doi: 10.1186/s12880-024-01465-4.
This study aims to assess the consistency of various CT-FFR software, to determine the reliability of current CT-FFR software, and to measure relevant influence factors. The goal is to build a solid foundation of enhanced workflow and technical principles that will ultimately improve the accuracy of measurements of coronary blood flow reserve fractions. This improvement is critical for assessing the level of ischemia in patients with coronary heart disease.
103 participants were chosen for a prospective research using coronary computed tomography angiography (CCTA) assessment. Heart rate, heart rate variability, subjective picture quality, objective image quality, vascular shifting length, and other factors were assessed. CT-FFR software including K software and S software are used for CT-FFR calculations. The consistency of the two software is assessed using paired-sample t-tests and Bland-Altman plots. The error classification effect is used to construct the receiver operating characteristic curve.
The CT-FFR measurements differed significantly between the K and S software, with a statistical significance of P < 0.05. In the Bland-Altman plot, 6% of the points (14 out of 216) fell outside the 95% consistency level. Single-factor analysis revealed that heart rate variability, vascular dislocation offset distance, subjective image quality, and lumen diameter significantly influenced the discrepancies in CT-FFR measurements between two software programs (P < 0.05). The ROC curve shows the highest AUC for the vessel shifting length, with an optimal cut-off of 0.85 mm.
CT-FFR measurements vary among software from different manufacturers, leading to potential misclassification of qualitative diagnostics. Vessel shifting length, subjective image quality score, HRv, and lumen diameter impacted the measurement stability of various software.
本研究旨在评估各种 CT-FFR 软件的一致性，以确定当前 CT-FFR 软件的可靠性，并测量相关影响因素。目的是建立一个增强工作流程和技术原则的坚实基础，最终提高冠状动脉血流储备分数测量的准确性。这一改进对于评估冠心病患者的缺血程度至关重要。
采用前瞻性研究方法，对 103 例患者进行冠状动脉计算机断层扫描血管造影（CCTA）评估。评估心率、心率变异性、主观图像质量、客观图像质量、血管移位长度等因素。使用 K 软件和 S 软件等 CT-FFR 软件进行 CT-FFR 计算。采用配对样本 t 检验和 Bland-Altman 图评估两种软件的一致性。采用误差分类效果构建受试者工作特征曲线。
K 软件和 S 软件的 CT-FFR 测量值差异显著，具有统计学意义（P < 0.05）。在 Bland-Altman 图中，有 6%的点（216 个点中的 14 个）超出了 95%一致性水平。单因素分析显示，心率变异性、血管脱位偏移距离、主观图像质量和管腔直径显著影响两种软件程序 CT-FFR 测量值的差异（P < 0.05）。ROC 曲线显示血管移位长度的 AUC 最高，最佳截断值为 0.85mm。
来自不同制造商的软件的 CT-FFR 测量值存在差异，可能导致定性诊断的错误分类。血管移位长度、主观图像质量评分、HRv 和管腔直径影响各种软件的测量稳定性。
