Improving CT-Derived Fractional Flow Reserve Analysis: A Quality Improvement Initiative

Area of Science:

• Cardiovascular Imaging
• Medical Imaging Quality Improvement

Background:

• Fractional flow reserve derived from CT angiography (FFRCT) analysis requires high-quality coronary computed tomography angiography (CCTA) imaging.
• Suboptimal CCTA quality can lead to lower FFRCT analysis acceptance rates, impacting clinical decision-making.

Purpose of the Study:

• To identify factors influencing CCTA quality for FFRCT analysis.
• To implement and evaluate quality improvement strategies for CCTA acquisition.

Main Methods:

• Initial quality control analysis of 30 CCTA studies.
• Implementation of a standardized CCTA protocol focusing on heart rate control and nitroglycerin administration.
• Ongoing quality assessment of 60 CCTA studies post-intervention and analysis of FFRCT acceptance rates.

Main Results:

• The institution's FFRCT acceptance rate improved from 76.1% to 90% post-intervention.
• This improvement surpassed the initial institutional rate but remained below the national average of >95%.

Conclusions:

• Establishing and adhering to standardized CCTA imaging protocols is crucial for improving image quality.
• Comprehensive training and buy-in from CT technologists and nurses are vital for successful quality improvement initiatives.
• Standardized CCTA protocols enhance imaging quality and positively impact patient care through improved FFRCT analysis.