Introduction: Rapid technological advances in computed tomography (CT) have allowed CT coronary angiography (CTCA) to be delivered at low radiation dose and high diagnostic accuracy. Due to its high negative predictive value for coronary artery disease, it has become a gatekeeper for the assessment of patients with chest pain of recent onset. Second line functional assessment of a detected coronary stenosis relies mostly on other imaging modalities. Functional assessment of coronary artery disease by CT is therefore an attractive addition to CTCA.Areas covered: This review will discuss the current evidence base and future development for CT perfusion imaging. Furthermore, this review will discuss CT-derived fractional flow reserve and CT coronary plaque characteristics as alternative approaches for functional evaluation of coronary artery disease. Finally, combining coronary anatomy and functional assessment of coronary flow with myocardial tissue characterization by CT may be attractive allowing triple assessment by CT.Expert commentary: The combined use of CTCA and functional assessment of coronary artery stenosis by CT perfusion or CT-derived fractional flow reserve is an attractive diagnostic pathway that requires further evaluation.

Functional assessment of coronary artery disease by cardiac computed tomography

Rossi, A;
2017-01-01

Abstract

Introduction: Rapid technological advances in computed tomography (CT) have allowed CT coronary angiography (CTCA) to be delivered at low radiation dose and high diagnostic accuracy. Due to its high negative predictive value for coronary artery disease, it has become a gatekeeper for the assessment of patients with chest pain of recent onset. Second line functional assessment of a detected coronary stenosis relies mostly on other imaging modalities. Functional assessment of coronary artery disease by CT is therefore an attractive addition to CTCA.Areas covered: This review will discuss the current evidence base and future development for CT perfusion imaging. Furthermore, this review will discuss CT-derived fractional flow reserve and CT coronary plaque characteristics as alternative approaches for functional evaluation of coronary artery disease. Finally, combining coronary anatomy and functional assessment of coronary flow with myocardial tissue characterization by CT may be attractive allowing triple assessment by CT.Expert commentary: The combined use of CTCA and functional assessment of coronary artery stenosis by CT perfusion or CT-derived fractional flow reserve is an attractive diagnostic pathway that requires further evaluation.
2017
CT FFR
Cardiac computed tomography
myocardial perfusion imaging
Computed Tomography Angiography
Coronary Angiography
Coronary Artery Disease
Coronary Stenosis
Fractional Flow Reserve, Myocardial
Humans
Plaque, Atherosclerotic
Predictive Value of Tests
Tomography, X-Ray Computed
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11699/59396
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