The importance of three dimensional coronary artery reconstruction accuracy when computing virtual fractional flow reserve from invasive angiography
Abstract Three dimensional (3D) coronary anatomy, reconstructed from coronary angiography (CA), is now being used as the basis to compute ‘virtual’ fractional flow reserve (vFFR), and thereby guide treatment decisions in patients with coronary artery disease (CAD). Reconstruction accuracy is therefo...
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Nature Portfolio
2021
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oai:doaj.org-article:f68f07091b844a7cad1110d6d918e83f2021-12-02T18:01:41ZThe importance of three dimensional coronary artery reconstruction accuracy when computing virtual fractional flow reserve from invasive angiography10.1038/s41598-021-99065-72045-2322https://doaj.org/article/f68f07091b844a7cad1110d6d918e83f2021-10-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-99065-7https://doaj.org/toc/2045-2322Abstract Three dimensional (3D) coronary anatomy, reconstructed from coronary angiography (CA), is now being used as the basis to compute ‘virtual’ fractional flow reserve (vFFR), and thereby guide treatment decisions in patients with coronary artery disease (CAD). Reconstruction accuracy is therefore important. Yet the methods required remain poorly validated. Furthermore, the magnitude of vFFR error arising from reconstruction is unkown. We aimed to validate a method for 3D CA reconstruction and determine the effect this had upon the accuracy of vFFR. Clinically realistic coronary phantom models were created comprosing seven standard stenoses in aluminium and 15 patient-based 3D-printed, imaged with CA, three times, according to standard clinical protocols, yielding 66 datasets. Each was reconstructed using epipolar line projection and intersection. All reconstructions were compared against the real phantom models in terms of minimal lumen diameter, centreline and surface similarity. 3D-printed reconstructions (n = 45) and the reference files from which they were printed underwent vFFR computation, and the results were compared. The average error in reconstructing minimum lumen diameter (MLD) was 0.05 (± 0.03 mm) which was < 1% (95% CI 0.13–1.61%) compared with caliper measurement. Overall surface similarity was excellent (Hausdorff distance 0.65 mm). Errors in 3D CA reconstruction accounted for an error in vFFR of ± 0.06 (Bland Altman 95% limits of agreement). Errors arising from the epipolar line projection method used to reconstruct 3D coronary anatomy from CA are small but contribute to clinically relevant errors when used to compute vFFR.Roshni SolankiRebecca GoslingVignesh RammohanGiulia PederzaniPankaj GargJames HeppenstallD. Rodney HosePatricia V. LawfordAndrew J. NarracottJohn FennerJulian P. GunnPaul D. MorrisNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-12 (2021) |
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DOAJ |
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Medicine R Science Q |
| spellingShingle |
Medicine R Science Q Roshni Solanki Rebecca Gosling Vignesh Rammohan Giulia Pederzani Pankaj Garg James Heppenstall D. Rodney Hose Patricia V. Lawford Andrew J. Narracott John Fenner Julian P. Gunn Paul D. Morris The importance of three dimensional coronary artery reconstruction accuracy when computing virtual fractional flow reserve from invasive angiography |
| description |
Abstract Three dimensional (3D) coronary anatomy, reconstructed from coronary angiography (CA), is now being used as the basis to compute ‘virtual’ fractional flow reserve (vFFR), and thereby guide treatment decisions in patients with coronary artery disease (CAD). Reconstruction accuracy is therefore important. Yet the methods required remain poorly validated. Furthermore, the magnitude of vFFR error arising from reconstruction is unkown. We aimed to validate a method for 3D CA reconstruction and determine the effect this had upon the accuracy of vFFR. Clinically realistic coronary phantom models were created comprosing seven standard stenoses in aluminium and 15 patient-based 3D-printed, imaged with CA, three times, according to standard clinical protocols, yielding 66 datasets. Each was reconstructed using epipolar line projection and intersection. All reconstructions were compared against the real phantom models in terms of minimal lumen diameter, centreline and surface similarity. 3D-printed reconstructions (n = 45) and the reference files from which they were printed underwent vFFR computation, and the results were compared. The average error in reconstructing minimum lumen diameter (MLD) was 0.05 (± 0.03 mm) which was < 1% (95% CI 0.13–1.61%) compared with caliper measurement. Overall surface similarity was excellent (Hausdorff distance 0.65 mm). Errors in 3D CA reconstruction accounted for an error in vFFR of ± 0.06 (Bland Altman 95% limits of agreement). Errors arising from the epipolar line projection method used to reconstruct 3D coronary anatomy from CA are small but contribute to clinically relevant errors when used to compute vFFR. |
| format |
article |
| author |
Roshni Solanki Rebecca Gosling Vignesh Rammohan Giulia Pederzani Pankaj Garg James Heppenstall D. Rodney Hose Patricia V. Lawford Andrew J. Narracott John Fenner Julian P. Gunn Paul D. Morris |
| author_facet |
Roshni Solanki Rebecca Gosling Vignesh Rammohan Giulia Pederzani Pankaj Garg James Heppenstall D. Rodney Hose Patricia V. Lawford Andrew J. Narracott John Fenner Julian P. Gunn Paul D. Morris |
| author_sort |
Roshni Solanki |
| title |
The importance of three dimensional coronary artery reconstruction accuracy when computing virtual fractional flow reserve from invasive angiography |
| title_short |
The importance of three dimensional coronary artery reconstruction accuracy when computing virtual fractional flow reserve from invasive angiography |
| title_full |
The importance of three dimensional coronary artery reconstruction accuracy when computing virtual fractional flow reserve from invasive angiography |
| title_fullStr |
The importance of three dimensional coronary artery reconstruction accuracy when computing virtual fractional flow reserve from invasive angiography |
| title_full_unstemmed |
The importance of three dimensional coronary artery reconstruction accuracy when computing virtual fractional flow reserve from invasive angiography |
| title_sort |
importance of three dimensional coronary artery reconstruction accuracy when computing virtual fractional flow reserve from invasive angiography |
| publisher |
Nature Portfolio |
| publishDate |
2021 |
| url |
https://doaj.org/article/f68f07091b844a7cad1110d6d918e83f |
| work_keys_str_mv |
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