FFR_CT derived from computed tomography angiography: the experience in the UK

Area of Science:

• Cardiology
• Medical Imaging
• Computational Fluid Dynamics

Background:

• Non-invasive fractional flow reserve derived from CT coronary angiography (FFR_CT) is a novel technology for investigating coronary artery disease.
• It utilizes computational fluid dynamics applied to anatomical data for functional assessment in clinical decision-making.
• FFR_CT received medical technology approval in the UK in February 2017.

Purpose of the Study:

• To discuss the principles behind non-invasive FFR calculation.
• To compare commercially available FFR_CT technologies.
• To examine diagnostic accuracy, cost-effectiveness, and safety, and discuss clinical implications in the UK.

Main Methods:

• Review of mathematical and physiological principles of non-invasive FFR.
• Analysis of early clinical trial data on diagnostic accuracy, cost-effectiveness, and safety.
• Discussion of implications for clinical practice in the UK.

Main Results:

• Non-invasive FFR_CT provides both anatomical and physiological data for accurate diagnosis of obstructive coronary artery disease.
• Early clinical trials indicate promising diagnostic accuracy and safety.
• Cost-effectiveness in real-world cohorts remains to be proven.

Conclusions:

• Non-invasive FFR_CT is a promising imaging technology for diagnosing coronary artery disease.
• Further evidence on cost-effectiveness in real-world settings is required for integration into UK clinical practice and guidelines.