Noninvasive Computed Tomography–Derived Fractional Flow Reserve Based on Structural and Fluid Analysis: Reproducibility of On-site Determination by Unexperienced Observers

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The aim of this study was to evaluate the reproducibility of computed tomography (CT)–derived fractional flow reserve (FFR) determined on site by inexperienced observers using a postprocessing software based on structural and fluid analysis.


Using 21 coronary vessels in 7 patients who underwent 320-row coronary CT angiography and catheter-FFR, 2 independent inexperienced observers (A: a student radiation technologist; B: a nonmedical staff) determined the CT-FFR using a postprocessing software. After a 20-minute training session, both observers postprocessed all vessels and readjusted their settings after another training/feedback. These CT-FFRs were compared with values determined by an expert analyst.


The mean processing times were 23 ± 4 minutes (automatic), 71 ± 5 minutes (observer A), and 57 ± 7 minutes (observer B) per patient. The initial correlations with expert data were r = 0.92 (observer A) and 0.73 (observer B) and increased to 0.83 for observer B after additional training. The final absolute difference with the expert data was 0.000 to 0.020. The correlation between catheter-FFR and expert CT-FFR was r = 0.76.


The CT-derived FFR on-site postprocessing software showed good reproducibility for measurements by inexperienced observers.

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