CT-FFR Non-invasive Physiology — EECC MCQ
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Correct answer: A — CT-FFR uses computational fluid dynamics applied to standard CTCA data to estimate FFR non-invasively — a CT-FFR ≤0.80 identifies haemodynamically significant lesions, potentially avoiding the need for invasive angiography with FFR in some patients
CT-FFR (HeartFlow, Siemens cFFR) uses computational fluid dynamics (CFD) algorithms applied to standard coronary CTA datasets to compute the FFR at every point in the coronary tree — WITHOUT adenosine or invasive catheterisation. Clinical evidence: PLATFORM, ADVANCE, and NXT trials showed CT-FFR: (1) identifies haemodynamically significant lesions (≤0.80 threshold, same as invasive FFR); (2) high diagnostic accuracy vs invasive FFR (AUC ~0.90); (3) reduces unnecessary invasive angiography (reclassifies ~60% of CTCA-positive lesions as non-significant); (4) safe to defer revascularisation when CT-FFR >0.80. The 2024 ESC CCS Guidelines include CT-FFR as a tool for assessing the haemodynamic significance of coronary lesions identified on CTCA (Class IIa). CT-FFR provides anatomical AND functional assessment from a single non-invasive test — the 'one-stop-shop' for stable CCS evaluation.
Reference: ESC (2024): CCS Guidelines; NXT/PLATFORM Trials