P6187Multicentre diagnostic performance of on-site workstation CT derived fractional flow reserve

Abstract

Abstract Background On-site workstation based computed tomography derived fractional flow reserve (CT-FFR) is an emerging method to assess vessel specific ischaemia in coronary artery disease (CAD). Global data on its diagnostic performance when compared with CT coronary angiography (CTA) is limited. Purpose To evaluate the on-site multicentre diagnostic performance of reduced-order CT-FFR at detecting vessel specific ischaemia. Method This is a retrospective pooled analysis of 141 patients (204 vessels) with suspected CAD enrolled from 3 global centres who underwent CTA, onsite CT-FFR and invasive FFR. On-site CT-FFR was performed using a reduced order model on a standard desktop computer with dedicated software. The per vessel diagnostic performance of CT-FFR (≤0.8) for vessel specific ischemia (FFR≤0.8) was compared with CTA (≥50% stenosis). Results Mean age was 65.8±9.9, 70.7% were male. FFR significant stenosis was present in 34.3% (70/204) of vessels. Pearson correlation of CT-FFR for invasive FFR was 0.52, P<0.001. Bland Altman analysis demonstrated a mean difference of 0.06±0.15 (95% limits of agreement −0.22 to 0.35). Per vessel diagnostic accuracy, sensitivity and specificity of CT-FFR and CTA were 79.9% vs 53.5%; 78.6% vs 85.7%; 80.6% vs 35.9% respectively. Diagnostic performance as assessed by area under the receiver operator curve (AUC) for CT FFR was superior to CTA (0.82 [95% CI 0.76–0.88] vs 0.61 [0.55–0.67]; P<0.001). Conclusion On-site workstation CT-FFR demonstrated high per vessel diagnostic performance and was superior when compared with CTA in assessment of vessel specific ischaemia as assessed by invasive FFR in a multicentre setting.