Fractional flow reserve modeled from resting coronary CT angiography: state of the science.

OBJECTIVE. The purpose of this article is to discuss recent technologic innovations that enable noninvasive calculation of fractional flow reserve (FFR) from CT. CONCLUSION. FFR CT is superior to coronary CT angiography (CTA) stenosis for the diagnosis of ischemia-causing lesions. FFR CT improves the diagnostic accuracy mostly by reducing the false-positive rates incorrectly classified by CTA stenosis alone. Furthermore, in patients in whom CT shows an intermediate stenosis-wherein the results of CT alone are the most clinically ambiguous for ischemia diagnosis-FFR CT shows significantly higher diagnostic performance than CT alone.