The Society of Cardiovascular Computed Tomography (SCCT) and the Society for Cardiovascular Angiography and Interventions (SCAI) have published an expert consensus document on the use of coronary CT angiography (CCTA)-derived fractional flow reserve (FFR-CT) for assessing coronary artery disease.
Published in the Journal of Cardiovascular Computed Tomography and endorsed by the American College of Cardiology (ACC), the document provides evidence-based guidance on the acquisition, interpretation, and reporting of FFR-CT. Key recommendations include the following:
- High-quality CCTA imaging is essential for accurate FFR-CT computation, with nitroglycerin and heart rate control improving diagnostic accuracy. Motion artifacts and calcification can affect FFR-CT reliability.
- FFR-CT has its greatest clinical utility in patients with stable chest pain and intermediate stenosis to guide revascularization decisions.
- FFR-CT values should be integrated into CCTA reports, with stenosis-specific values measured 2 cm distal to the lesion, which the writing group said has the most robust evidence base for clinical outcomes and longer-term prognosis.
The consensus document covers acquisition, diagnostic accuracy, clinical applications including stable chest pain, multivessel disease, and acute chest pain, as well as prognostic value and future directions.
