title: Noninvasive FFR derived from coronary CT angiography in the management of coronary artery disease: technology and clinical update.
abstract: After a decade of clinical use of coronary computed tomographic angiography (CCTA) to evaluate the anatomic severity of coronary artery disease, new methods of deriving functional information from CCTA have been developed. These methods utilize the anatomic information provided by CCTA in conjunction with computational fluid dynamics to calculate fractional flow reserve (FFR) values from CCTA image data sets. Computed tomography-derived FFR (CT-FFR) enables the identification of lesion-specific drop noninvasively. A three-dimensional CT-FFR modeling technique, which provides FFR values throughout the coronary tree (HeartFlow FFRCT analysis), has been validated against measured FFR and is now approved by the US Food and Drug Administration for clinical use. This technique requires off-site supercomputer analysis. More recently, a one-dimensional computational analysis technique (Siemens cFFR), which can be performed on on-site workstations, has been developed and is currently under investigation. This article reviews CT-FFR technology and clinical evidence for its use in stable patients with suspected coronary artery disease.
authors.affiliation: Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA, USA.
authors.forename: Rine
authors.initials: R
authors.lastname: Nakanishi
authors.affiliation: Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA, USA.
authors.forename: Mathew J
authors.initials: MJ
authors.lastname: Budoff
mesh_terms: D000072226:Computed Tomography Angiography / Q000191:economics; D017023:Coronary Angiography / Q000191:economics / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000191:economics / Q000503:physiopathology / Q000628:therapy; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000191:economics / Q000503:physiopathology / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003362:Cost-Benefit Analysis; D053805:Fractional Flow Reserve, Myocardial; D017048:Health Care Costs; D006801:Humans; D008955:Models, Cardiovascular; D009204:Myocardial Revascularization; D011237:Predictive Value of Tests; D011379:Prognosis; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D012720:Severity of Illness Index
keywords: FFRCT; cFFR; coronary computed tomographic angiography; fractional flow reserve