Fractional flow reserve measurement by computed tomography: An alternative to the stress test

Recent advances in computed tomographic technology have contributed towards improving coronary computed tomography angiography (CCTA) in determining the severity of coronary artery disease anatomically. Although the viability of CCTA has most often been confined to anatomical assessment, recent development has enabled evaluation of the haemodynamic significance of coronary artery disease. In light of this, CCTA-derived fractional flow reserve (FFR_CT), a novel imaging modality, now permits the physiological assessment of coronary artery disease. To date, several studies have documented the diagnostic performance of FFR_CT, and more trials are being performed that will further substantiate this technique. The present paper provides an overview and discussion of the available evidence for FFR_CT in the clinical setting as well as potential future directions of FFR_CT.