Diagnostic Accuracy of Fractional Flow Reserve From Anatomic CT Angiography

Abstract

Coronary computed tomographic (CT) angiography is a noninvasive test that enables direct visualization of coronary artery disease (CAD) and correlates favorably with invasive coronary angiography (ICA) for measures of stenosis severity.¹ However, CT cannot determine the hemodynamic significance of CAD, and even among CT-identified obstructive stenoses confirmed by ICA, fewer than half are ischemia-causing.^2,3 These findings underscore an unreliable relationship of stenosis severity to ischemia and have raised concerns that use of CT may precipitate unnecessary ICA and coronary revascularization for patients who do not have ischemia.^4,5