摘要Background Non-invasive computed tomography angiography(CTA)-based fractional flow reserve(CT-FFR)could become a gatekeeper to invasive coronary angiography.Deep learning(DL)-based CT-FFR has shown promise when compared to invasive FFR.To evaluate the performance of a DL-based CT-FFR technique,DeepVessel FFR(DVFFR).Methods This retrospective study was designed for iScheMia Assessment based on a Retrospective,single-center Trial of CT-FFR(SMART).Patients suspected of stable coronary artery disease(CAD)and undergoing both CTA and invasive FFR examina-tions were consecutively selected from the Beijing Anzhen Hospital between January 1,2016 to December 30,2018.FFR obtained during invasive coronary angiography was used as the reference standard.DVFFR was calculated blindly using a DL-based CT-FFR approach that utilized the complete tree structure of the coronary arteries.Results Three hundred and thirty nine patients(60.5±10.0 years and 209 men)and 414 vessels with direct invasive FFR were included in the analysis.At per-vessel level,sensitivity,specificity,accuracy,positive predictive value(PPV)and negative pre-dictive value(NPV)of DVFFR were 94.7％,88.6％,90.8％,82.7％,and 96.7％,respectively.The area under the receiver operating characteristics curve(AUC)was 0.95 for DVFFR and 0.56 for CTA-based assessment with a significant difference(P＜0.0001).At patient level,sensitivity,specificity,accuracy,PPV and NPV of DVFFR were 93.8％,88.0％,90.3％,83.0％,and 95.8％,respectively.The computation for DVFFR was fast with the average time of 22.5±1.9 s.Conclusions The results demonstrate that DVFFR was able to evaluate lesion hemodynamic significance accurately and effect-ively with improved diagnostic performance over CTA alone.Coronary artery disease(CAD)is a critical disease in which coron-ary artery luminal narrowing may result in myocardial ischemia.Early and effective assessment of myocardial ischemia is essen-tial for optimal treatment planning so as to improve the quality of life and reduce medical costs.