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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doaj-f68f07091b844a7cad1110d6d918e83f2021-10-10T11:29:13ZengNature Publishing GroupScientific Reports2045-23222021-10-0111111210.1038/s41598-021-99065-7The importance of three dimensional coronary artery reconstruction accuracy when computing virtual fractional flow reserve from invasive angiographyRoshni Solanki0Rebecca Gosling1Vignesh Rammohan2Giulia Pederzani3Pankaj Garg4James Heppenstall5D. Rodney Hose6Patricia V. Lawford7Andrew J. Narracott8John Fenner9Julian P. Gunn10Paul D. Morris11Department of Infection, Immunity and Cardiovascular Disease, The Medical School, University of SheffieldDepartment of Infection, Immunity and Cardiovascular Disease, The Medical School, University of SheffieldDepartment of Infection, Immunity and Cardiovascular Disease, The Medical School, University of SheffieldDepartment of Infection, Immunity and Cardiovascular Disease, The Medical School, University of SheffieldInsigneo Institute for In Silico Medicine, University of SheffieldDepartment of Radiology, Sheffield Teaching Hospitals NHS Foundation TrustDepartment of Infection, Immunity and Cardiovascular Disease, The Medical School, University of SheffieldDepartment of Infection, Immunity and Cardiovascular Disease, The Medical School, University of SheffieldDepartment of Infection, Immunity and Cardiovascular Disease, The Medical School, University of SheffieldDepartment of Infection, Immunity and Cardiovascular Disease, The Medical School, University of SheffieldDepartment of Infection, Immunity and Cardiovascular Disease, The Medical School, University of SheffieldDepartment of Infection, Immunity and Cardiovascular Disease, The Medical School, University of SheffieldAbstract 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.https://doi.org/10.1038/s41598-021-99065-7 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
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 |
spellingShingle |
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 Scientific Reports |
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 Publishing Group |
series |
Scientific Reports |
issn |
2045-2322 |
publishDate |
2021-10-01 |
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. |
url |
https://doi.org/10.1038/s41598-021-99065-7 |
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