Journal: Cardiovascular Diagnosis and Therapy

Article Title: Prognostic value of CT-derived myocardial blood flow, CT fractional flow reserve and high-risk plaque features for predicting major adverse cardiac events

doi: 10.21037/cdt-21-219

Figure Lengend Snippet: Flow chart of inclusion and exclusion. CCTA, coronary computed tomography angiography; CT-MPI, computed tomography myocardial perfusion imaging; MACE, major adverse cardiac event.

Article Snippet: Plaque analysis and CT-FFR simulation CCTA datasets were reconstructed with smooth kernel (Bv 40) and third generation iterative reconstruction (IR) technique (strength 3, ADMIRE, Siemens).

Techniques: Computed Tomography, Imaging

Journal: Cardiovascular Diagnosis and Therapy

Article Title: Prognostic value of CT-derived myocardial blood flow, CT fractional flow reserve and high-risk plaque features for predicting major adverse cardiac events

doi: 10.21037/cdt-21-219

Figure Lengend Snippet: Representative case of patient with MACE. An 86-year-old male with stable angina underwent CCTA + dynamic CT-MPI. CCTA showed mixed plaque with moderate stenosis at proximal LAD. This lesion was revealed to be HRP feature free and hemodynamically insignificant with CT-FFR value of 0.82. However, dynamic CT-MPI demonstrated decreased myocardial perfusion of apical anterior and apical lateral segments, with MBFischemic of 85 mL/100 mL/min. This patient underwent late revascularization of LAD lesion due to aggravated angina symptom at follow-up of 27 months after index test. CCTA, coronary computed tomography angiography; CT-FFR, computed tomography fractional flow reserve; CT-MPI, computed tomography myocardial perfusion imaging; LAD, left anterior descending; LAP, low attenuation plaque; MACE, major adverse cardiac event; MBF, myocardial blood flow; PR, positive remodeling.

Article Snippet: Plaque analysis and CT-FFR simulation CCTA datasets were reconstructed with smooth kernel (Bv 40) and third generation iterative reconstruction (IR) technique (strength 3, ADMIRE, Siemens).

Techniques: Computed Tomography, Imaging

Journal: Annals of Translational Medicine

Article Title: Diagnostic performance of CT-derived resting distal to aortic pressure ratio (resting Pd/Pa) vs. CT-derived fractional flow reserve (CT-FFR) in coronary lesion severity assessment

doi: 10.21037/atm-21-4325

Figure Lengend Snippet: Schematic presentation of the CT-FFR and CT-(Pd/Pa)rest analysis. (A) Invasive FFR was measured 20 mm distal (white star) to the LAD stenosis of a 64 years old male patient. Invasive resting Pd/Pa was measured before vasodilator administration, while invasive FFR was measured following the standard procedures. (B) The three steps of CT-FFR and CT-(Pd/Pa)rest calculation procedures. CT-FFR, computed tomography angiography-derived fractional flow reserve. Step 1: a medical imaging tool whose performance was well validated at KTH (20,21) was applied to extract detailed coronary arterial trees with aorta included; Step 2: with respect to fluid dynamics, accuracy of blood flow related dynamics, including derived index such as resting Pd/Pa and FFR, is very sensitive to the provided coronary blood flow (CBF). Different from simplified but widely used models (16), this work has particularly calibrated the CBF for each interested branch via making full use of information implicitly embodied in the CT image for each specific patient. The detailed derivations of current approach can be found in (22) and its clinical evaluation is published in (23); Step 3: Once coronary tree and CBF are ready, the computational fluid dynamics simulation (OpenFOAM ver1912 OpenCFD Ltd.) was carried out for the calculation of CT-(Pd/Pa)rest and CT-FFR.

Article Snippet: The detailed derivations of current approach can be found in ( 22 ) and its clinical evaluation is published in ( 23 ); Step 3: Once coronary tree and CBF are ready, the computational fluid dynamics simulation (OpenFOAM ver1912 OpenCFD Ltd.) was carried out for the calculation of CT-(Pd/Pa) rest and CT-FFR.

Techniques: Computed Tomography, Derivative Assay, Imaging