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CT-FFR — EECC MCQ

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ModerateCoronary Artery DiseaseCT-FFREECC

A 50-year-old woman with atypical chest pain and low-intermediate PTP has a CTCA showing a 50% stenosis in the mid-LAD. The radiologist reports a CT-derived fractional flow reserve (CT-FFR) value of 0.75 for the lesion. What does this indicate?

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Correct answer: D — A CT-FFR ≤0.80 suggests the lesion is haemodynamically significant and correlates with a positive invasive FFR, supporting consideration of invasive assessment or revascularisation

CT-derived FFR (CT-FFR) uses computational fluid dynamics applied to standard CTCA datasets to estimate the haemodynamic significance of coronary lesions non-invasively. The PLATFORM and FORECAST trials demonstrated that CT-FFR improves diagnostic accuracy over CTCA anatomy alone, reducing unnecessary invasive angiography. A CT-FFR ≤0.80 correlates well with invasive FFR ≤0.80 (haemodynamically significant). The 2024 ESC CCS Guidelines include CT-FFR as an option for functional assessment of intermediate coronary lesions detected on CTCA (Class IIa), potentially avoiding the need for separate invasive FFR assessment. Limitations include image quality requirements and computational processing time.

Reference: ESC (2024): CCS Guidelines; PLATFORM/FORECAST Trials