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Aging Neurosci."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Increasing attention has been paid to the hemodynamic evaluation of cerebral arterial stenosis. We aimed to demonstrate the performance of angiography-based quantitative flow ratio (QFR) to assess hemodynamic alterations caused by luminal stenoses, using invasive fractional pressure ratios (FPRs) as a reference standard.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between March 2013 and December 2019, 29 patients undergoing the pressure gradient measurement of cerebral atherosclerosis were retrospectively enrolled. Wire-based FPR was defined by the arterial pressure distal to the stenotic lesion (Pd) to proximal (Pa) pressure ratios (Pd\/Pa). FPR &amp;lt; 0.70 or FPR &amp;lt; 0.75 was assumed as hemodynamically significant stenosis. The new method of computing QFR from a single angiographic view, i.e., the Murray law-based QFR, was applied to the interrogated vessel. An artificial intelligence algorithm was developed to realize the automatic delineation of vascular contour.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fractional pressure ratio and QFR were assessed in 38 vessels from 29 patients. Excellent correlation and agreement were observed between QFR and FPR [<jats:italic>r<\/jats:italic> = 0.879, <jats:italic>P<\/jats:italic> &amp;lt; 0.001; mean difference (bias): \u22120.006, 95% limits of agreement: \u22120.198 to 0.209, respectively). Intra-observer and inter-observer reliability in QFR were excellent (intra-class correlation coefficients, 0.996 and 0.973, respectively). For predicting FPR &amp;lt; 0.70, the area under the receiver-operating characteristic curves (AUC) of QFR was 0.946 (95% CI, 0.820 to 0.993%). The sensitivity and specificity of QFR &amp;lt; 0.70 for identifying FPR &amp;lt; 0.70 was 88.9% (95% CI, 65.3 to 98.6%) and 85.0% (95% CI, 62.1 to 96.8%). For predicting FPR &amp;lt; 0.75, QFR showed similar performance with an AUC equal to 0.926.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Computational QFR from a single angiographic view achieved comparable results to the wire-based FPR. The excellent diagnostic performance and repeatability empower QFR with high feasibility in the functional assessment of cerebral arterial stenosis.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnagi.2022.813648","type":"journal-article","created":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T14:18:29Z","timestamp":1643725109000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["Functional Assessment of Cerebral Artery Stenosis by Angiography-Based Quantitative Flow Ratio: A Pilot Study"],"prefix":"10.3389","volume":"14","author":[{"given":"Kangmo","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weihe","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunfei","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunxiao","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruidong","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wusheng","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengxian","family":"Tu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinfeng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,2,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1001\/jamacardio.2016.0263","article-title":"Association of coronary stenosis and plaque morphology with fractional flow reserve and outcomes.","volume":"1","author":"Ahmadi","year":"2016","journal-title":"JAMA Cardiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1161\/STROKEAHA.118.023996","article-title":"WEAVE Trial.","volume":"50","author":"Alexander","year":"2019","journal-title":"Stroke"},{"key":"B3","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1136\/neurintsurg-2020-016208","article-title":"The WOVen trial: wingspan one-year vascular events and neurologic outcomes.","volume":"2020","author":"Alexander","year":"2020","journal-title":"J. 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