TY - JOUR
T1 - Inter- and intraoperator variability in measurement of on-site ct-derived fractional flow reserve based on structural and fluid analysis
T2 - A comprehensive analysis
AU - Kumamaru, Kanako K.
AU - Angel, Erin
AU - Sommer, Kelsey N.
AU - Iyer, Vijay
AU - Wilson, Michael F.
AU - Agrawal, Nikhil
AU - Bhardwaj, Aishwarya
AU - Kattel, Sharma B.
AU - Kondziela, Sandra
AU - Malhotra, Saurabh
AU - Manion, Christopher
AU - Pogorzelski, Katherine
AU - Ramanan, Tharmathai
AU - Sawant, Abhishek C.
AU - Suplicki, Mary M.
AU - Waheed, Sameer
AU - Fujimoto, Shinichiro
AU - Sharma, Umesh C.
AU - Rybicki, Frank J.
AU - Ionita, Ciprian N.
N1 - Publisher Copyright:
© RSNA, 2019.
PY - 2019/8
Y1 - 2019/8
N2 - Purpose To measure the inter- and intraobserver variability among operators of varying expertise in conducting CT-derived fractional flow reserve (CT FFR) measurements on-site by using structural and fluid analysis and to evaluate differences in reproducibility between two different training methods for end users. Materials and Methods This retrospective analysis of the prospectively enrolled cohort included 22 symptomatic patients who underwent both 320–detector row coronary CT angiography and catheter-derived fractional flow reserve (FFR) within 90 days. Thirteen operators of varying expertise were assigned to one of two training arms: Arm 1, on-site training by a specialist in CT FFR technology; arm 2, self-training through use of written materials. After the training, all 13 operators reviewed the CT data and measured CT FFR in 24 vessels in 22 patients. Inter- and intraoperator variability and agreements between CT FFR and catheter-derived FFR measurements were evaluated. Results The overall intraclass correlation coefficient (ICC) among operators was 0.71 (95% confidence interval: 0.58, 0.83) with a mean absolute difference (± standard deviation) of 0.027 ± 0.022. The operators in arm 2 showed greater interoperator differences than those in arm 1 (0.031 ± 0.024 vs 0.023 ± 0.018; P =.024). Among operators who recalculated CT FFR, the mean CT FFR value did not significantly differ between the first and second calculations (ICC, 0.66; 95% confidence interval: 0.46, 0.87), with the medical specialists producing the lowest intraoperator variability (0.053 ± 0.060). The overall correlation coefficient between CT FFR and catheter FFR was r = 0.61, with a mean absolute difference of 0.096 ± 0.089. Conclusion Good reproducibility of CT FFR values calculated on-site on the basis of structural and fluid analysis was observed among operators of varying expertise. Face-to-face training sessions may cause less variability.
AB - Purpose To measure the inter- and intraobserver variability among operators of varying expertise in conducting CT-derived fractional flow reserve (CT FFR) measurements on-site by using structural and fluid analysis and to evaluate differences in reproducibility between two different training methods for end users. Materials and Methods This retrospective analysis of the prospectively enrolled cohort included 22 symptomatic patients who underwent both 320–detector row coronary CT angiography and catheter-derived fractional flow reserve (FFR) within 90 days. Thirteen operators of varying expertise were assigned to one of two training arms: Arm 1, on-site training by a specialist in CT FFR technology; arm 2, self-training through use of written materials. After the training, all 13 operators reviewed the CT data and measured CT FFR in 24 vessels in 22 patients. Inter- and intraoperator variability and agreements between CT FFR and catheter-derived FFR measurements were evaluated. Results The overall intraclass correlation coefficient (ICC) among operators was 0.71 (95% confidence interval: 0.58, 0.83) with a mean absolute difference (± standard deviation) of 0.027 ± 0.022. The operators in arm 2 showed greater interoperator differences than those in arm 1 (0.031 ± 0.024 vs 0.023 ± 0.018; P =.024). Among operators who recalculated CT FFR, the mean CT FFR value did not significantly differ between the first and second calculations (ICC, 0.66; 95% confidence interval: 0.46, 0.87), with the medical specialists producing the lowest intraoperator variability (0.053 ± 0.060). The overall correlation coefficient between CT FFR and catheter FFR was r = 0.61, with a mean absolute difference of 0.096 ± 0.089. Conclusion Good reproducibility of CT FFR values calculated on-site on the basis of structural and fluid analysis was observed among operators of varying expertise. Face-to-face training sessions may cause less variability.
UR - https://www.scopus.com/pages/publications/85085578691
U2 - 10.1148/ryct.2019180012
DO - 10.1148/ryct.2019180012
M3 - Article
AN - SCOPUS:85085578691
SN - 2638-6135
VL - 1
JO - Radiology: Cardiothoracic Imaging
JF - Radiology: Cardiothoracic Imaging
IS - 3
M1 - e180012
ER -