CT derived fractional flow reserve: Part 1 - Comprehensive review of methodologies
Publication date
2025-07
Authors
Shaikh, Kashif
Lozano, Patricia Rodriguez
Evangelou, Sotirios
Wu, En-Haw
Nurmohamed, Nick S
Madan, Nidhi
Verghese, Dhiran
Shekar, Chandana
Waheed, Anam
Siddiqui, Saira
Editors
Advisors
Supervisors
Document Type
Article
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taverne
Abstract
Advancements in cardiac computed tomography angiography (CCTA) have enabled the extraction of physiological data from an anatomy-based imaging modality. This review outlines the key methodologies for deriving fractional flow reserve (FFR) from CCTA, with a focus on two primary methods: 1) computational fluid dynamics-based FFR (CT-FFR) and 2) plaque-derived ischemia assessment using artificial intelligence and quantitative plaque metrics. These techniques have expanded the role of CCTA beyond anatomical assessment, allowing for concurrent evaluation of coronary physiology without the need for invasive testing. This review provides an overview of the principles, workflows, and limitations of each technique and aims to inform on the current state and future direction of non-invasive coronary physiology assessment.
Keywords
Computational fractional flow reserve, Coronary artery disease, Coronary computed tomography angiography, Taverne, Radiology Nuclear Medicine and imaging, Cardiology and Cardiovascular Medicine, Journal Article, Review
Citation
Shaikh, K, Lozano, P R, Evangelou, S, Wu, E-H, Nurmohamed, N S, Madan, N, Verghese, D, Shekar, C, Waheed, A, Siddiqui, S, Kolossváry, M, Almeida, S, Coombes, T, Suchá, D, Trivedi, S J, Ihdayhid, A R & SCCT FiRST (Fellow and Resident Leaders of SCCT) Committee 2025, 'CT derived fractional flow reserve : Part 1 - Comprehensive review of methodologies', Journal of cardiovascular computed tomography, vol. 19, no. 4, pp. 390-396. https://doi.org/10.1016/j.jcct.2025.07.001