http://www.theheart.org/web_slides/1254947.do A prospective multicenter study to determine the diagnostic performance of noninvasive fractional flow reserve (FFRCT) ws invasively measured fractional flow reserve (FFR)

1. DISCOVER FLOW (Diagnosis of ischemia-
causing stenoses obtained via non-
invasive fractional flow reserve)

2. DISCOVER FLOW (Diagnosis of ischemia-causing
stenoses obtained via non-invasive fractional flow reserve)
Bon-Kwon Koo (Seoul National University Hospital, Korea)
EuroPCR 2011
• Objective:
A prospective multicenter study to determine the diagnostic performance of
noninvasive fractional flow reserve (FFRCT) vs invasively measured fractional
flow reserve (FFR)
• Patients and treatment:
Patients with stenosis in a major epicardial coronary artery ≥2 mm identified
by CT angiography underwent invasive angiography with FFR (lesion-specific
ischemia defined as an FFR <0.80)
CT angiograms were then mapped using the noninvasive FFRCT technology
Noninvasive computed FFRCT values were then compared with those of FFR
actually obtained in the patients

3. DISCOVER FLOW: Results
• Noninvasive computed FFRCT values were found to yield nearly identical results
to FFR, with a very high degree of correlation
• Looking at the CT angiograms alone, without the computational FFR, the scans
scored well for sensitivity and negative predictive value but had lower scores, in
the range of 40 to 60, for specificity, positive predictive value, and overall accuracy
• FFRCT produced sensitivity and negative predictive value scores similar to those
of CT alone but much higher scores—in the 80s—for specificity and positive
predictive value
• Overall accuracy score was increased by 25% with the FFRCT values

4. DISCOVER FLOW: Commentary*
"This noninvasive 'all-in-one' technology may reduce unnecessary invasive
coronary angiography and revascularization procedures."
- Dr Bon-Kwon Koo
"[FFR and other imaging tests can] distract from the overall picture and leave
behind unfinished work."
- Dr Bernhard Meier
"We should remember that these computerized models cannot substitute for clinical
judgment. When you have a patient with angina and a 70% lesion, you feel
compelled to intervene, regardless of the FFR results."
- Dr Ron Waksman
*All comments from Adding function to CTA with "noninvasive FFR" ups accuracy, may cut
procedures: DISCOVER FLOW (http://www.theheart.org/article/1227905.do)

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