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Proceedings Paper

Study of the effect of boundary conditions on fractional flow reserve using patient specific coronary phantoms
Author(s): Kelsey N. Sommer; Lauren M. Shepard; Vijay Iyer; Erin Angel; Michael F. Wilson; Frank J. Rybicki; Dimitrios Mitsouras; Ciprian N. Ionita
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Paper Abstract

Purpose: 3D printing has become an accepted radiological tool which allow accurate physical renderings of organs for diagnosis and treatment planning. Use of 3D printed phantoms to replicate blood flow conditions have been reported, however, comprehensive studies comparing in-patients and in-vitro measurements are scarce. We propose to study whether 3D-printed patient specific coronary benchtop models, can be used to study how variations in outflow boundary conditions influence benchtop fractional flow reserve (FFR) measurements and how these compare with a research CT-FFR software. Materials and Methods: Fifty-two CT-derived patient-specific 3D-printed coronary phantoms were used for comprehensive flow experiments and a benchtop-FFR (B-FFR) was evaluated along the diseased arteries. A programmable cardiac pulsatile pump provided six coronary outflow rates equally distributed between normal and hyperemic blood flow conditions (250-500 mL/min). B-FFR results were compared to catheter lab Invasive-FFR (IFFR) measurements and a CT-FFR research software. The effect of coronary outflow changes was compared with catheter lab diagnosis using operator characteristics (ROC) and Area Under ROC (AUROC). Results: The highest AUROC was for B-FFR-500, 0.82 (95% CI: 0.65-0.92,), and gradually decreased as the flow rate decreased to B-FFR-250, 0.79 (95% CI: 0.70-0.87). The CT-FFR AUROC was 0.80 (95% CI: 0.69-0.86). Conclusion: 3D-printed patient specific coronary phantoms and controlled flow experiments demonstrated significant agreement between hyperemic simulated flow B-FFR-500 and I-FFR. We also observed not negligible variations of the B-FFR for small coronary outflow rates changes, implying that slight changes in outflow conditions may results in diagnosis change, especially in the 0.75-0.85 FFR range.

Paper Details

Date Published: 28 February 2020
PDF: 12 pages
Proc. SPIE 11317, Medical Imaging 2020: Biomedical Applications in Molecular, Structural, and Functional Imaging, 113171J (28 February 2020); doi: 10.1117/12.2548472
Show Author Affiliations
Kelsey N. Sommer, Univ. at Buffalo (United States)
Canon Stroke and Vascular Research Ctr. (United States)
Lauren M. Shepard, Univ. at Buffalo (United States)
Canon Stroke and Vascular Research Ctr. (United States)
Vijay Iyer, Canon Stroke and Vascular Research Ctr. (United States)
Univ. at Buffalo Jacobs School of Medicine (United States)
Erin Angel, Canon Medical Systems USA, Inc. (United States)
Michael F. Wilson, Canon Stroke and Vascular Research Ctr. (United States)
Univ. at Buffalo Jacobs School of Medicine (United States)
Frank J. Rybicki, Univ. of Cincinnati (United States)
Dimitrios Mitsouras, Brigham and Women's Hospital (United States)
Ciprian N. Ionita, Univ. at Buffalo (United States)
Canon Stroke and Vascular Research Ctr. (United States)


Published in SPIE Proceedings Vol. 11317:
Medical Imaging 2020: Biomedical Applications in Molecular, Structural, and Functional Imaging
Andrzej Krol; Barjor S. Gimi, Editor(s)

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