Review: FFRCT Changing the Face of Cardiac CT

Abstract

Non-invasive fractional flow reserve derived from CT coronary angiography (FFRCT) offers an amalgamation of both coronary anatomy and physiology. This review aims to provide a contemporary evaluation of the evidence for clinical use of FFRCT. The review article pays particular attention to the importance of patient preparation, anatomical features, scan quality and the overall interpretation of results that can lead to the best use of FFRCT analysis. Previous cost evaluations of the technology are compared and reviewed. Diagnostic accuracy of FFRCT in comparison with CTA has been established in several clinical studies previously. More recent studies for FFRCT use have focused on the clinical utility of the technology, in comparison with other non-invasive testing for coronary artery disease and the prognostic data of FFRCT. The registry data has demonstrated FFRCT as a comparable indicator of cardiac prognosis to invasive fractional flow reserve. Future research areas include the use of FFRCT to plan coronary revascularisation prior to procedures and even perhaps to predict future cardiac event using computational flow dynamic data. FFRCT is now an established technology for the diagnosis of coronary artery disease with increasing use in clinical practice. The potential of the technology to deliver cost savings, improved triage and more directed management will depend upon the manner of its use. Future applications of the principles of FFRCT have broad potential for improved understanding of coronary artery disease and superior management of patients afflicted with it.