ArticleCatheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions2026
VERMONT μQFR: Diagnostic Accuracy of Murray Law-Based 2D-μQFR Compared to 3D-μQFR and vFFR.
Article in Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMurray law-based quantitative flow ratio (μQFR) is an angiography-derived physiological index that utilizes a single angiographic projection with artificial intelligence-guided vessel segmentation.
aimsTo evaluate the diagnostic accuracy and time efficacy of 2D-μQFR against wire-based fractional flow reserve (FFR ≤ 0.80), compare its performance with 3D-μQFR and vessel-FFR (vFFR), and assess feasibility in lesions excluded from vFFR analysis.
methodsThis sub-study of the prospective VERMONT trial analyzed 2D- and 3D-μQFR retrospectively using prospectively acquired angiograms, with wire-based FFR as the reference standard.
resultsAmong 209 patients with 225 intermediate lesions, 205 lesions were analyzed. 2D-μQFR demonstrated excellent diagnostic accuracy for FFR ≤ 0.80 (AUC 0.95; 95% CI 0.93-0.98), with 93% sensitivity, 92% specificity, 88% positive predictive value (PPV), and 95% negative predictive value (NPV). Inter-observer agreement was excellent (r = 0.94, p < 0.001), and 2D-μQFR analysis was 15.1 min faster than wire-based FFR (1.8 ± 0.7 vs. 16.9 ± 5.4 min, p < 0.001). Diagnostic performance was comparable to that of 3D-μQFR, which achieved an AUC of 0.94 (95% CI 0.91-0.97), with 89% sensitivity, 90% specificity, 86% PPV, and 93% NPV. It was more specific than vFFR, which achieved an AUC of 0.92 (95% CI 0.89-0.96), with 90% sensitivity, 79% specificity, 74% PPV, and 93% NPV. Single-projection analysis was feasible in 85% of lesions excluded from vFFR due to image quality limitations.
conclusionSingle-projection 2D-μQFR provides accurate, rapid, and reproducible physiological assessment comparable to 3D-μQFR with superior specificity to vFFR. These findings support 2D-μQFR as a practical, wire-free alternative to invasive FFR in routine clinical practice.
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