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6. Editor's note to the September 2021 issue

Author

Reiber, J.H.C.

Subjects
medicine.medical_specialty, business.industry, Medicine, Radiology, Nuclear Medicine and imaging, Medical physics, Cardiology and Cardiovascular Medicine, business, Cardiac imaging
Published
2021

7. Introduction topical issue on CT plaque burden

Author

Reiber, J.H.C.

Subjects
Coronary angiography, medicine.medical_specialty, medicine.diagnostic_test, Computed Tomography Angiography, business.industry, MEDLINE, Coronary Artery Disease, Coronary Angiography, Prognosis, Coronary Vessels, Severity of Illness Index, Plaque, Atherosclerotic, Predictive Value of Tests, Predictive value of tests, Severity of illness, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Radiology, Cardiology and Cardiovascular Medicine, business, Cardiac imaging, Introductory Journal Article, Computed tomography angiography
Published
2020
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15. User-agent cooperation in multiagent IVUS image segmentation

Author

Bovenkamp, E.G.P., Dijkstra, J., Bosch, J.G., and Reiber, J.H.C.

Subjects
Intravascular ultrasonography -- Analysis, Algorithms -- Analysis, Algorithm, Business, Electronics, Electronics and electrical industries, Health care industry
Abstract

Automated interpretation of complex images requires elaborate knowledge and model-based image analysis, but often needs interaction with an expert as well. This research describes expert interaction with a multiagent image interpretation system using only a restricted vocabulary of high-level user interactions. The aim is to minimize inter- and intra-observer variability by keeping the total number of interactions as low and simple as possible. The multiagent image interpretation system has elaborate high-level knowledge-based control over low-level image segmentation algorithms. Agents use contextual knowledge to keep the number of interactions low but, when in doubt, present the user with the most likely interpretation of the situation. The user, in turn, can correct, supplement, and/or confirm the results of image-processing agents. This is done at a very high level of abstraction such that no knowledge of the underlying segmentation methods, parameters or agent functioning is needed. High-level interaction thereby replaces more traditional contour correction methods like inserting points and/or (re)drawing contours. This makes it easier for the user to obtain good results, while inter- and intra-observer variability are kept minimal, since the image segmentation itself remains under control of image-processing agents. The system has been applied to intravascular ultrasound (IVUS) images. Experiments show that with an average of 2-3 high-level user interactions per correction, segmentation results substantially improve while the variation is greatly reduced. The achieved level of accuracy and repeatability is equivalent to that of manual drawing by an expert. Index Terms--Cooperative systems, image segmentation, knowledge based systems.

Published
2009

16. A randomised controlled trial of the sirolimus-eluting biodegradable polymer ultra-thin Supraflex stent versus the everolimus-eluting biodegradable polymer SYNERGY stent for three-vessel coronary artery disease: rationale and design of the Multivessel TALENT trial

Author

Hara, H., Gao, C., Kogame, N., Ono, M., Kawashima, H., Wang, R.T., Morel, M.A., O'Leary, N., Sharif, F., Mollmann, H., Reiber, J.H.C., Sabate, M., Zaman, A., Wijns, W., Onuma, Y., Serruys, P.W., Multivessel TALENT Trial Investiga, Graduate School, ACS - Atherosclerosis & ischemic syndromes, ACS - Heart failure & arrhythmias, and ACS - Microcirculation

Subjects
medicine.medical_specialty, stable angina, Polymers, medicine.medical_treatment, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Coronary Artery Disease, law.invention, Coronary artery disease, All institutes and research themes of the Radboud University Medical Center, Percutaneous Coronary Intervention, multiple vessel disease, Randomized controlled trial, law, Internal medicine, Intravascular ultrasound, Absorbable Implants, medicine, Clinical endpoint, drug-eluting stent, Humans, Everolimus, Prospective Studies, cardiovascular diseases, Sirolimus, medicine.diagnostic_test, business.industry, Stent, Percutaneous coronary intervention, Drug-Eluting Stents, medicine.disease, Clinical trial, Treatment Outcome, Conventional PCI, Cardiology, Stents, Cardiology and Cardiovascular Medicine, business
Abstract

Aims The purpose of the Multivessel TALENT trial is to compare clinical outcomes of the novel Supraflex Cruz stent with those of the SYNERGY stent in patients with three-vessel disease (3VD) undergoing state-of-the-art percutaneous coronary intervention (PCI). Methods and results In this prospective, randomised, 1:1 balanced, multicentre, open-label trial, 1,550 patients with de novo 3VD without left main disease will be assigned to the Supraflex Cruz or SYNERGY arm. The following treatment principles of "best practice" PCI will be applied: Heart Team consensus based on SYNTAX score II treatment recommendation, functional lesion evaluation by quantitative flow ratio (QFR), stent optimisation by intravascular imaging, optimal pharmacological treatment and prasugrel monotherapy. The primary endpoint is a non-inferiority comparison of the patient-oriented composite endpoint (POCE) of all-cause death, any stroke, any myocardial infarction, or any revascularisation, at 12 months post procedure. The powered secondary endpoint is a superiority comparison of the vessel-oriented composite endpoint (VOCE), defined as vessel-related cardiovascular death, vessel-related myocardial infarction, or clinically and physiologically indicated target vessel revascularisation, at 24 months. Conclusions The Multivessel TALENT trial will be evaluating a novel treatment strategy for complex coronary artery disease with state-of-the-art PCI based on angiography-derived QFR with novel ultra-thin Supraflex Cruz stents, compared with SYNERGY stents. Clinical Trial Registration URL: https://www.clinicaltrials.gov/ct2/show/NCT04390672. Unique Identifier: NCT04390672 Visual summary. Flow chart of the Multivessel TALENT trial. 3VD: three-vessel disease; QFR: quantitative flow ratio; IVUS: intravascular ultrasound; OCT: optical coherence tomography; CTO: chronic total occlusion; OMT: optimal medical therapy; POCE: patient-oriented composite endpoint; VOCE: vessel-oriented composite endpoint.

Published
2020

18. Preclinical evaluation of a thin-strut bioresorbable scaffold (ArterioSorb)

Author

Katagiri, Y., Torii, R., Takahashi, K., Tenekecioglu, E., Asano, T., Chichareon, P., Tomaniak, M., Piek, J.J., Wykrzykowska, J.J., Bullett, N., Ahmed, N., Al-Lamee, K., Al-Lamee, R., Leclerc, G., Kitslaar, P., Dijkstra, J., Reiber, J.H.C., Poon, E.K.W., Bourantas, C.V., Gijsen, F., Serruys, P.W., Onuma, Y., and Cardiology

Subjects
optical coherence tomography, QCA, bioresorbable scaffolds, drug-eluting stent
Abstract

Aims: The aim of this study was to assess the acute performance of the 95 mu m ArterioSorb oriented poly L-lactic acid (PLLA) scaffold in comparison with the XIENCE metallic drug-eluting stent (DES) in porcine coronary arteries.Methods and results: In 15 non-atherosclerotic Yucatan mini pigs, the ArterioSorb (3.0/14 mm) and XIENCE (3.0/15 mm) were implanted in 25 and 15 vessels, respectively. Acute performance was evaluated by using quantitative coronary angiography (QCA) and optical coherence tomography (OCT). Following three-dimensional reconstruction of the coronary arteries, endothelial shear stress (ESS) was quantified using non-Newtonian steady-flow simulation. Acute recoil measured by QCA was comparable in the two aims. Post-procedural flow and scaffold/stent area by OCT did not differ between the two devices. ESS post procedure was comparable between ArterioSorb and XIENCE (2.21 +/- 1.97 vs 2.25 +/- 1.71 Pa, p=0.314).Conclusions: Acute recoil, luminal dimensions and ESS in the ArterioSorb oriented PLLA scaffold with thin struts of 95 mu m were comparable to those in the XIENCE metallic DES.

Published
2020

19. The SYNTAX score on its way out or ... towards artificial intelligence: part

Author

Serruys, P.W., Chichareon, P., Modolo, R., Leaman, D.M., Reiber, J.H.C., Emanuelsson, H., Mario, C. di, Pijls, N.H.J., Morel, M.A., Valgimigli, M., Farooq, V., Klaveren, D. van, Capodanno, D., Andreini, D., Bourantas, C.V., Davies, J., Banning, A.P., Escaned, J., Piek, J.J., Echavarria-Pinto, M., Taylor, C.A., Thomsen, B., Collet, C., Pompilio, G., Bartorelli, A.L., Glocker, B., Dressler, O., Stone, G.W., and Onuma, Y.

Published
2020

20. Predictive value of the QFR in detecting vulnerable plaques in non-flow limiting lesions: a combined analysis of the PROSPECT and IBIS-4 study

Author

Safi, H. (Hannah), Bourantas, C.V. (Christos), Ramasamy, A. (Anantharaman), Zanchin, T. (Thomas), Bär, S. (Sarah), Tufaro, V. (Vincenzo), Jin, C. (Chongying), Torii, K. (Kan), Karagiannis, A. (Alexios), Reiber, J.H.C. (Johan), Mathur, A. (Anthony), Onuma, Y. (Yoshinubo), Windecker, S.W. (Stephan), Lansky, A.J. (Alexandra), Maehara, A. (Akiko), Serruys, P.W.J.C. (Patrick), Stone, P.H. (Peter), Baumbach, A. (Andreas), Stone, G.W. (Gregg), Räber, L. (Lorenz), Safi, H. (Hannah), Bourantas, C.V. (Christos), Ramasamy, A. (Anantharaman), Zanchin, T. (Thomas), Bär, S. (Sarah), Tufaro, V. (Vincenzo), Jin, C. (Chongying), Torii, K. (Kan), Karagiannis, A. (Alexios), Reiber, J.H.C. (Johan), Mathur, A. (Anthony), Onuma, Y. (Yoshinubo), Windecker, S.W. (Stephan), Lansky, A.J. (Alexandra), Maehara, A. (Akiko), Serruys, P.W.J.C. (Patrick), Stone, P.H. (Peter), Baumbach, A. (Andreas), Stone, G.W. (Gregg), and Räber, L. (Lorenz)

Abstract

Studies have shown that the quantitative flow ratio (QFR), recently introduced to assess lesion severity from coronary angiography, provides useful prognostic information; however the additive value of this technique over intravascular imaging in detecting lesions that are likely to cause events is yet unclear. We analysed data acquired in the PROSPECT

Published
2020
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24. Neuro-fuzzy systems for computer-aided myocardial viability assessment

Author

Behloul, F., Lelieveldt, B.P.F., Boudraa, A., Janier, M.F., Revel, D., and Reiber, J.H.C.

Subjects
Heart, Cardiography -- Technology application, Computer-aided medical diagnosis -- Models, Business, Electronics, Electronics and electrical industries, Health care industry
Abstract

This paper describes a multimodality framework for computer-aided myocardial viability assessment based on neuro-fuzzy techniques. The proposed approach distinguishes two main levels: the modality-independent inference level and the modality-dependent application level. This two-level distinction releases the hard constraint of multimodality image registration. An abstract description template is used to describe the different myocardial functions (contractile function, perfusion, metabolism). Parameters extracted from different image modalities are combined to derive a diagnostic image. The neuro-fuzzy techniques make our system transparent, adaptive and easily extendable. Its effectiveness and robustness are demonstrated in a positronn emission tomography/magnetic resonance imaging data fusion application. Index Terms--Computer-aided diagnosis, data fusion, myocardial viability, neuro-fuzzy systems.

Published
2001

29. Angiography-Derived Fractional Flow Reserve in the SYNTAX II Trial Feasibility, Diagnostic Performance of Quantitative Flow Ratio, and Clinical Prognostic Value of Functional SYNTAX Score Derived From Quantitative Flow Ratio in Patients With 3-Vessel Disease

Author

Asano, T., Katagiri, Y., Chang, C.C., Kogame, N., Chichareon, P., Takahashi, K., Modolo, R., Tenekecioglu, E., Collet, C., Jonker, H., Appleby, C., Zaman, A., Mieghem, N. van, Uren, N., Zueco, J., Piek, J.J., Reiber, J.H.C., Farooq, V., Escaned, J., Banning, A.P., Serruys, P.W., Onuma, Y., Graduate School, ACS - Atherosclerosis & ischemic syndromes, ACS - Heart failure & arrhythmias, ACS - Microcirculation, and Cardiology

Subjects
Male, Cardiac Catheterization, Clinical Trials as Topic, functional SYNTAX score, Time Factors, quantitative flow ratio, Coronary Stenosis, Drug-Eluting Stents, Coronary Artery Disease, Middle Aged, Coronary Angiography, Coronary Vessels, Risk Assessment, Fractional Flow Reserve, Myocardial, Percutaneous Coronary Intervention, Treatment Outcome, Predictive Value of Tests, Risk Factors, Feasibility Studies, Humans, Female, Coronary Artery Bypass, 3-vessel disease, Aged, Retrospective Studies
Abstract

OBJECTIVES The aims of the present study were to investigate the applicability of quantitative flow ratio (QFR) in patients with 3-vessel disease and to demonstrate the impact of functional SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score derived from QFR (fSS(QFR)) on clinical outcomes.BACKGROUND The applicability of QFR in patients with 3-vessel disease and the feasibility of fSS(QFR) have not yet been investigated.METHODS All lesions interrogated using instantaneous wave-free ratio and/or fractional flow reserve in the SYNTAX II trial were retrospectively screened and analyzed for QFR. The diagnostic performance of QFR was investigated using hybrid wire-derived pressure assessment (instantaneous wave-free ratio and fractional flow reserve), used in the trial as a reference. Patients with analyzable QFR in 3 vessels were stratified according to fSS(QFR) to evaluate its clinical prognostic value on the basis of 2-year patient-oriented composite endpoint.RESULTS QFRs were analyzable in 71.0% of lesions (836 lesions). The diagnostic performance of QFR to predict binary wire-based ischemia was substantial (area under the curve 0.81, accuracy 73.8%), with a positive predictive value of 85.9%. Independent predictors of diagnostic discordance were lesions in side branches, involvement of bifurcation or trifurcation, and small vessel. According to the 2-year patient-oriented composite endpoint, fSS(QFR) reclassified 26.1% of the patients (36 of 138) in the high-to intermediate-risk group into the low-risk group appropriately (net reclassification improvement 0.32; p < 0.001). The area under the curve for fSS(QFR) to predict the 2-year patient-oriented composite endpoint was higher than that of the classic anatomic SYNTAX score (0.68 vs. 0.56; p = 0.002).CONCLUSIONS QFR demonstrated substantial applicability in patients with 3-vessel disease. The fSS(QFR) has the potential to further refine prognostic risk estimation compared with the classic anatomic SYNTAX score. (c) 2019 by the American College of Cardiology Foundation.

Published
2019

34. Correlation between annual change in health status and computer tomography derived lung density in subjects with [α.sub.1]-antitrypsin deficiency

Author

Stolk, J., Ng, W.H., Bakker, M.E., Reiber, J.H.C., Rabe, K.F., Putter, H., and Stoel, B.C.

Subjects
Health
Abstract

Thorax 2003;58: 1027-1030 Background: There is increasing recognition that questionnaires of health status and lung density measurements are more sensitive tools for assessing progression of emphysema than forced expiratory volume [...]

Published
2003

35. Relationship of peripheral arterial compliance and standard cardiovascular risk factors

Author

Willens, Howard J., Davis, Warren, Herrington, David M., Wade, Karen, Kesler, Karen, Mallon, Steve, Brown, W. Virgil, Reiber, J.H.C., and Raines, Jeffrey K.

Subjects
Peripheral vascular diseases -- Development and progression -- Risk factors -- Complications and side effects, Peripheral circulation -- Measurement -- Health aspects, Cardiovascular diseases -- Risk factors -- Development and progression -- Complications and side effects, Health
Abstract

Abnormalities of peripheral arterial compliance are clinically useful markers of atherosclerosis and risk of vascular events. Local peripheral arterial compliance can be easily and accurately assessed in the clinic by [...]

Published
2003

40. Post-implantation shear stress assessment: an emerging tool for differentiation of bioresorbable scaffolds

Author

Tenekecioglu, E. (Erhan), Torii, K. (Kan), Katagiri, Y. (Yuki), Chichareon, P. (Ply), Asano, T. (Taku), Miyazaki, Y. (Yosuke), Takahashi, K. (Kuniaki), Modolo, R. (Rodrigo), Al-Lamee, R. (Rasha), Al-Lamee, K. (Kadem), Colet, C. (Carlos), Reiber, J.H.C. (Johan), Pekkan, K. (Kerem), Geuns, R.J.M. (Robert Jan) van, Bourantas, C.V. (Christos), Onuma, Y. (Yoshinobu), Serruys, P.W.J.C. (Patrick), Tenekecioglu, E. (Erhan), Torii, K. (Kan), Katagiri, Y. (Yuki), Chichareon, P. (Ply), Asano, T. (Taku), Miyazaki, Y. (Yosuke), Takahashi, K. (Kuniaki), Modolo, R. (Rodrigo), Al-Lamee, R. (Rasha), Al-Lamee, K. (Kadem), Colet, C. (Carlos), Reiber, J.H.C. (Johan), Pekkan, K. (Kerem), Geuns, R.J.M. (Robert Jan) van, Bourantas, C.V. (Christos), Onuma, Y. (Yoshinobu), and Serruys, P.W.J.C. (Patrick)

Abstract

Optical coherence tomography based computational flow dynamic (CFD) modeling provides detailed information about the local flow behavior in stented/scaffolded vessel segments. Our aim is to investigate the in-vivo effect of strut thickness and strut protrusion on endothelial wall shear stress (ESS) distribution in ArterioSorb Absorbable Drug-Eluting Scaffold (ArterioSorb) and Absorb everolimus-eluting Bioresorbable Vascular Scaffold (Absorb) devices that struts with similar morphology (quadratic structure) but different thickness. In three animals, six coronary arteries were treated with ArterioSorb. At different six animals, six coronary arteries were treated with Absorb. Following three-dimensional(3D) reconstruction of the coronary arteries, Newtonian steady flow simulation was performed and the ESS were estimated. Mixed effects models were used to compare ESS distribution in the two devices. There were 4591 struts in the analyzed 477 cross-sections in Absorb (strut thickness = 157 µm) and 3105 struts in 429 cross-sections in ArterioSorb (strut thickness = 95 µm) for the protrusion analysis. In cross-section level analysis, there was significant difference between the scaffolds in the protrusion distances. The protrusion was higher in Absorb (97% of the strut thickness) than in ArterioSorb (88% of the strut thickness). ESS was significantly higher in ArterioSorb (1.52 ± 0.34 Pa) than in Absorb (0.73 ± 2.19 Pa) (p = 0.001). Low- and very-low ESS data were seen more often in Absorb than in ArterioSorb. ArterioSorb is associated with a more favorable ESS distribution compared to the Absorb. These differences should be attributed to different strut thickness/strut protrusion that has significant effect on shear stress distribution.

Published
2018
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41. A novel software tool for semi-automatic quantification of thoracic aorta dilatation on baseline and follow-up computed tomography angiography

Author

Gao, X. (Xinpei), Boccalini, S. (Sara), Kitslaar, P.H. (Pieter), Budde, R.P.J. (Ricardo), Tu, S. (Shengxian), Lelieveldt, B.P.F. (Boudewijn), Dijkstra, J. (Jouke), Reiber, J.H.C. (Johan), Gao, X. (Xinpei), Boccalini, S. (Sara), Kitslaar, P.H. (Pieter), Budde, R.P.J. (Ricardo), Tu, S. (Shengxian), Lelieveldt, B.P.F. (Boudewijn), Dijkstra, J. (Jouke), and Reiber, J.H.C. (Johan)

Abstract

A dedicated software package that could semi-automatically assess differences in aortic maximal cross-sectional diameters from consecutive CT scans would most likely reduce the post-processing time and effort by the physicians. The aim of this study was to present and assess the quality of a new tool for the semi-automatic quantification of thoracic aorta dilation dimensions. Twenty-nine patients with two CTA scans of the thoracic aorta for which the official clinical report indicated an increase in aortic diameters were included in the study. Aortic maximal cross-sectional diameters of baseline and follow-up studies generated semi-automatically by the software were compared with corresponding manual measurements. The semi-automatic measurements were performed at seven landmarks defined on the baseline scan by two operators. Bias, Bland–Altman plots and intraclass correlation coefficients were calculated between the two methods and, for the semi-automatic software, also between two observers. The average time difference between the two scans of a single patient was 1188 ± 622 days. For the semi-automatic software, in 2 out of 29 patients, manual interaction was necessary; in the remaining 27 patients (93.1%), semi-automatic results were generated, demonstrating excellent intraclass correlation coefficients (all values ≥ 0.91) and small differences, especially for the proximal aortic arch (baseline: 0.19 ± 1.30 mm; follow-up: 0.44 ± 2.21 mm), the mid descending aorta (0.37 ± 1.64 mm; 0.37 ± 2.06 mm), and the diaphragm (0.30 ± 1.14 mm; 0.37 ± 1.80 mm). The inter-observer variability was low with all errors in diameters ≤ 1 mm, and intraclass correlation coefficients all ≥ 0.95. The semi-automatic tool decreased the processing time by 40% (13 vs. 22 min). In this work, a semi-automatic software package that allows the assessment of thoracic aorta diameters from baseline and follow-up CTs (and their differences), was presented, and demonstrated high accuracy and low int

Published
2018
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47. Quantitative angiography methods for bifurcation lesions: a consensus statement update from the European Bifurcation Club

Author

Collet, C., Onuma, Y., Cavalcante, R., Grundeken, M., Genereux, P., Popma, J., Costa, R., Stankovic, G., Tu, S., Reiber, J.H.C., Aben, J.P., Lassen, J.F., Louvard, Y., Lansky, A., Serruys, P.W., Byrne, R.A., Capodanno, D., Waksman, R., Garcia-Garcia, H.M., Arbab-Zadeh, A., EAPCI Sci Documents Comm, EAPCI, ACS - Heart failure & arrhythmias, Graduate School, ACS - Amsterdam Cardiovascular Sciences, and Cardiology

Subjects
Coronary angiography, medicine.medical_specialty, Consensus, Coronary Artery Disease, 030204 cardiovascular system & hematology, Coronary Angiography, Severity of Illness Index, Radiographic image interpretation, 03 medical and health sciences, 0302 clinical medicine, Medicine, Humans, Medical physics, 030212 general & internal medicine, Bifurcation lesion, Bifurcation, Statement (computer science), business.industry, Quantitative angiography, Coronary Stenosis, Vessel diameter, Bifurcation analysis, bifurcation, quantitative coronary angiography (QCA), Radiographic Image Interpretation, Computer-Assisted, Other imaging modalities, Cardiology and Cardiovascular Medicine, business, Software
Abstract

Bifurcation lesions represent one of the most challenging lesion subsets in interventional cardiology. The European Bifurcation Club (EBC) is an academic consortium whose goal has been to assess and recommend the appropriate strategies to manage bifurcation lesions. The quantitative coronary angiography (QCA) methods for the evaluation of bifurcation lesions have been subject to extensive research. Single-vessel QCA has been shown to be inaccurate for the assessment of bifurcation lesion dimensions. For this reason, dedicated bifurcation software has been developed and validated. These software packages apply the principles of fractal geometry to address the "step-down" in the bifurcation and to estimate vessel diameter accurately. This consensus update provides recommendations on the QCA analysis and reporting of bifurcation lesions based on the most recent scientific evidence from in vitro and in vivo studies and delineates future advances in the field of QCA dedicated bifurcation analysis.

Published
2017

50. Accuracy and reproducibility of fast fractional flow reserve computation from invasive coronary angiography

Author

Rosendael, A.R. van, Koning, G., Dimitriu-Leen, A.C., Smit, J.M., Montero-Cabezas, J.M., Kley, F. van der, Jukema, J.W., Reiber, J.H.C., Bax, J.J., Scholte, A.J.H.A., Rosendael, A.R. van, Koning, G., Dimitriu-Leen, A.C., Smit, J.M., Montero-Cabezas, J.M., Kley, F. van der, Jukema, J.W., Reiber, J.H.C., Bax, J.J., and Scholte, A.J.H.A.

Abstract

Contains fulltext : 182860.pdf (Publisher’s version ) (Open Access), Fractional flow reserve (FFR) guided percutaneous coronary intervention (PCI) is associated with favourable outcome compared with revascularization based on angiographic stenosis severity alone. The feasibility of the new image-based quantitative flow ratio (QFR) assessed from 3D quantitative coronary angiography (QCA) and thrombolysis in myocardial infarction (TIMI) frame count using three different flow models has been reported recently. The aim of the current study was to assess the accuracy, and in particular, the reproducibility of these three QFR techniques when compared with invasive FFR. QFR was derived (1) from adenosine induced hyperaemic coronary angiography images (adenosine-flow QFR [aQFR]), (2) from non-hyperemic images (contrast-flow QFR [cQFR]) and (3) using a fixed empiric hyperaemic flow [fixed-flow QFR (fQFR)]. The three QFR values were calculated in 17 patients who prospectively underwent invasive FFR measurement in 20 vessels. Two independent observers performed the QFR analyses. Mean difference, standard deviation and 95% limits of agreement (LOA) between invasive FFR and aQFR, cQFR and fQFR for observer 1 were: 0.01 +/- 0.04 (95% LOA: -0.07; 0.10), 0.01 +/- 0.05 (95% LOA: -0.08; 0.10), 0.01 +/- 0.04 (95% LOA: -0.06; 0.08) and for observer 2: 0.00 +/- 0.03 (95% LOA: -0.06; 0.07), -0.01 +/- 0.03 (95% LOA: -0.07; 0.05), 0.00 +/- 0.03 (95% LOA: -0.06; 0.05). Values between the 2 observers were (to assess reproducibility) for aQFR: 0.01 +/- 0.04 (95% LOA: -0.07; 0.09), for cQFR: 0.02 +/- 0.04 (95% LOA: -0.06; 0.09) and for fQFR: 0.01 +/- 0.05 (95% LOA: -0.07; 0.10). In a small number of patients we showed good accuracy of three QFR techniques (aQFR, cQFR and fQFR) to predict invasive FFR. Furthermore, good inter-observer agreement of the QFR values was observed between two independent observers.

Published
2017

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