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Automatic coronary blood flow computation: validation in quantitative flow ratio from coronary angiography
Yimin Zhang1,2, Su Zhang1,2, Jelmer Westra3
1Biomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
The International Journal of Cardiovascular Imaging
|December 12, 2018
Summary
A new automated method accurately calculates coronary flow velocity from angiography, enabling reliable quantitative flow ratio (QFR) assessment without pressure wires. This approach shows high diagnostic accuracy for coronary artery stenosis.
Area of Science:
- Cardiovascular imaging and intervention
- Computational fluid dynamics in medicine
- Medical image analysis
Background:
- Quantitative flow ratio (QFR) assesses coronary artery stenosis significance non-invasively.
- Current QFR methods rely on semi-automatic frame count, which is subjective and inconvenient.
- Accurate patient-specific coronary flow velocity computation is crucial for reliable QFR.
Purpose of the Study:
- To evaluate a novel automated approach for computing coronary flow velocity from angiograms.
- To derive quantitative flow ratio (QFRauto) using this automated flow velocity.
- To compare QFRauto with a commercial frame count method (QFRcount) and pressure wire-based fractional flow reserve (FFR).
Main Methods:
- Automated delineation of coronary vascular structures and centerline extraction from angiographic frames.
- Computation of flow velocity based on changes in centerline length.
- Selection of stable angiographic runs for 3D reconstruction and QFRauto calculation.
Main Results:
- QFRauto was successfully computed in 99% of vessels, demonstrating good contrast flow stability.
- QFRauto showed strong correlation and agreement with QFRcount (r=0.96) and FFR (r=0.83).
- Diagnostic accuracy of QFRauto for functionally significant stenosis (FFR ≤ 0.80) was 93.2%, with high sensitivity (92.4%) and specificity (93.7%).
Conclusions:
- Automated computation of patient-specific coronary flow velocity from angiography is feasible and reliable.
- QFRauto provides accurate assessment of coronary stenosis functional significance.
- This novel automated approach offers a promising alternative to existing QFR methods.
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