Gutiérrez-Chico JL, Chen Y, Yu W, Ding D, Huang J, Huang P, Jing J, Chu M, Wu P, Tian F, Xu B, Tu S. Diagnostic accuracy and reproducibility of optical flow ratio for functional evaluation of coronary stenosis in a prospective series.
Cardiol J 2020;
27:350-361. [PMID:
32436590 PMCID:
PMC8015995 DOI:
10.5603/cj.a2020.0071]
[Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 05/16/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND
Evaluating prospectively the feasibility, accuracy and reproducibility of optical flow ratio (OFR), a novel method of computational physiology based on optical coherence tomography (OCT).
METHODS AND RESULTS
Sixty consecutive patients (76 vessels) underwent prospectively OCT, angiography- based quantitative flow ratio (QFR) and fractional flow ratio (FFR). OFR was computed offline in a central core-lab by analysts blinded to FFR. OFR was feasible in 98.7% of the lesions and showed excellent agreement with FFR (ICCa = 0.83, r = 0.83, slope = 0.80, intercept = 0.17, kappa = 0.84). The area under curve to predict an FFR ≤ 0.80 was 0.95, higher than for QFR (0.91, p = 0.115) and for minimal lumen area (0.64, p < 0.001). Diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio were 93%, 92%, 93%, 88%, 96%, 13.8, 0.1, respectively. Median time to obtain OFR was 1.07 (IQR: 0.98-1.16) min, with excellent intraobserver and interobserver reproducibility (0.97 and 0.95, respectively). Pullback speed had negligible impact on OFR, provided the same coronary segment were imaged (ICCa = 0.90, kappa = 0.697).
CONCLUSIONS
The prospective computation of OFR is feasible and reproducible in a real-world series, resulting in excellent agreement with FFR, superior to other image-based methods.
Collapse