Comparative assessment of non-invasive imaging methods for coronary artery disease: coronary computed tomography angiography, computed tomography-derived fractional flow reserve and instantaneous wave-free ratio computed tomography.
Authors
Affiliations (2)
Affiliations (2)
- Department of Cardiology, Medical University of Warsaw, Warsaw, Poland. [email protected].
- Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
Abstract
Coronary artery disease remains a major worldwide health threat, requiring consistent developments in non-invasive diagnostic tools. Coronary Computed Tomography Angiography (CCTA) is frequently used for anatomical assessments of coronary arteries. However, its traditional limitation has been the inability to provide functional assessments of coronary lesions. The advent of CT-derived Fractional Flow Reserve (FFR<sub>CT</sub>) and Instantaneous Wave-Free Ratio derived from CT (iFR-CT) has addressed this gap by employing computational modeling to evaluate the hemodynamic significance of coronary stenosis. This review evaluates the diagnostic performance, and clinical impact of CCTA, FFR<sub>CT</sub> and iFR-CT. Studies indicate that FFR<sub>CT</sub> and iFR-CT improve diagnostic specificity and accuracy. Furthermore, research demonstrates that functional imaging influences downstream clinical management and provide significant prognostic information related to major adverse cardiac events. Moreover, advancements in Artificial Intelligence and patient-specific computational models are assessed for their diagnostic accuracy, their reductions in analysis time and their prognostic abilities. Despite these advancements, further clinical trials are fundamental to confirm long-term clinical benefits and standardization.