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Congress: ECR25
Poster Number: C-11699
Type: Poster: EPOS Radiologist (scientific)
Authorblock: I. Ayx, L. Lichti, S. Büttner, T. Papavassiliu, K. Sopova, S. O. Schönberg, M. Kuru, C. A. Marschner; Mannheim/DE
Disclosures:
Isabelle Ayx: Nothing to disclose
Lena Lichti: Nothing to disclose
Sylvia Büttner: Nothing to disclose
Theano Papavassiliu: Nothing to disclose
Kateryna Sopova: Nothing to disclose
Stefan Oswald Schönberg: Nothing to disclose
Mustafa Kuru: Nothing to disclose
Constantin Arndt Marschner: Nothing to disclose
Keywords: Artificial Intelligence, Cardiac, CT-Angiography, Diagnostic procedure, Arteriosclerosis
Purpose Coronary CT angiography (CCTA) is a valuable tool for excluding coronary artery disease, though its lack of specificity remains a limitation (1-3). To minimize unnecessary invasive catheter angiographies (ICA), current guidelines recommend the use of CT-derived fractional flow reserve (CT-FFR) to assess the hemodynamic significance of coronary artery stenosis (4). Additionally, the introduction of photon-counting CT (PCCT) has the potential to enhance CCTA by offering improved spatial and temporal resolution (5,6), which could, in turn, refine CT-FFR analysis for more...
Read more Methods and materials In this retrospective, single-center study, 28 patients (25 male, 3 female, median age 68 years) with obstructive coronary artery stenosis with a CAD RADS Score of 3 or 4a who underwent PCCT-CCTA and ICA were included. All patients were scanned on the novel first-generation whole-body dual-source PCCT system (NAEOTOM Alpha, Siemens Healthcare GmbH, Forchheim Germany) using a prospective electrocardiogram gated sequential mode with 120 kV. The contrast-enhanced angiographic scan was reconstructed with a slice thickness of 0.6 mm, an increment of...
Read more Results Patients were divided into CAD RADS 3 (9 patients, 6 male, 3 female, mean age 70 years, median Agatston Score 192.8) and CAD RADS 4a (19 patients, 19 male, 0 female, mean age 67 years, median Agatston Score 505.15). Revascularization was only performed in the CAD RADS 4a group, mean Delta CT-FR differed significantly between both groups (p = 0.0104). There was a significant correlation between the stenosis degree in CCTA and ICA (p = 0.0043), although a trend of overestimating...
Read more Conclusion Delta CT-FFR analysis using PCCT offers a feasible tool in identifying hemodynamically significant coronary artery stenosis and can help to reduce purely diagnostic ICA, opening the way for individual risk stratification in coronary artery disease.
Read more References   Douglas PS, Hoffmann U, Patel MR, et al (2015) Outcomes of Anatomical versus Functional Testing for Coronary Artery Disease. N Engl J Med 372:1291–1300. https://doi.org/10.1056/NEJMoa1415516 The SCOT-HEART Investigators (2018) Coronary CT Angiography and 5-Year Risk of Myocardial Infarction. N Engl J Med 379:924–933. https://doi.org/10.1056/NEJMoa1805971 Nørgaard BL, Leipsic J, Gaur S, et al (2014) Diagnostic Performance of Noninvasive Fractional Flow Reserve Derived From Coronary Computed Tomography Angiography in Suspected Coronary Artery Disease. Journal of the American College of Cardiology 63:1145–1155. https://doi.org/10.1016/j.jacc.2013.11.043 Baumann S, Renker...
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