Computational instantaneous wave-free ratio (IFR) for patient-specific coronary artery stenoses using 1D network models.

In this work, we estimate the diagnostic threshold of the instantaneous wave-free ratio (iFR) through the use of a one-dimensional haemodynamic framework. To this end, we first compared the computed fractional flow reserve (cFFR) predicted from a 1D computational framework with invasive clinical measurements. The framework shows excellent promise and utilises minimal patient data from a cohort of 52 patients with a total of 66 stenoses. The diagnostic accuracy of the cFFR model was 75.76%, with a sensitivity of 71.43%, a specificity of 77.78%, a positive predictive value of 60%, and a negative predictive value of 85.37%. The validated model was then used to estimate the diagnostic threshold of iFR. The model determined a quadratic relationship between cFFR and the ciFR. The iFR diagnostic threshold was determined to be 0.8910 from a receiver operating characteristic curve that is in the range of 0.89 to 0.9 that is normally reported in clinical studies.

Non-invasive coronary CT angiography-derived fractional flow reserve: A benchmark study comparing the diagnostic performance of four different computational methodologies.

Non-invasive coronary computed tomography (CT) angiography-derived fractional flow reserve (cFFR) is an emergent approach to determine the functional relevance of obstructive coronary lesions. Its feasibility and diagnostic performance has been reported in several studies. It is unclear if differences in sensitivity and specificity between these studies are due to study design, population, or "computational methodology." We evaluate the diagnostic performance of four different computational workflows for the prediction of cFFR using a limited data set of 10 patients, three based on reduced-order modelling and one based on a 3D rigid-wall model. The results for three of these methodologies yield similar accuracy of 6.5% to 10.5% mean absolute difference between computed and measured FFR. The main aspects of modelling which affected cFFR estimation were choice of inlet and outlet boundary conditions and estimation of flow distribution in the coronary network. One of the reduced-order models showed the lowest overall deviation from the clinical FFR measurements, indicating that reduced-order models are capable of a similar level of accuracy to a 3D model. In addition, this reduced-order model did not include a lumped pressure-drop model for a stenosis, which implies that the additional effort of isolating a stenosis and inserting a pressure-drop element in the spatial mesh may not be required for FFR estimation. The present benchmark study is the first of this kind, in which we attempt to homogenize the data required to compute FFR using mathematical models. The clinical data utilised in the cFFR workflows are made publicly available online.

Rotationally invariant pattern recognition by use of linear and nonlinear cascaded filters.

We discuss the merits of using single-layer (linear and nonlinear) and multiple-layer (nonlinear) filters for rotationally invariant and noise-tolerant pattern recognition. The capability of each approach is considered with reference to a two-class, rotation-invariant, character recognition problem. The minimum average correlation energy (MACE) filter is a linear filter that is generally accepted to be optimal for detecting signals that are free from noise. Here it is found that an optimized MACE filter cannot differentiate between the characters E and F in a rotation-invariant manner. We have found, however, that this task is possible when a single optimized linear filter is used to achieve the required response when a nonlinear threshold function is included after the filter. We show that this structure can be cascaded to form a multiple-layer, cascaded filter and that the capability of such a system is enhanced by its increased noise tolerance in the character recognition problem. Finally, we show the capability of a two-layer cascade as a means to detect different species of bacteria in images obtained from a phase-contrast microscope.