In this post I link to and excerpt from Coronary CT Angiography-derived Fractional Flow Reserve Testing in Patients with Stable Coronary Artery Disease: Recommendations on Interpretation and Reporting [PubMed Abstract] [Full Text HTML] [Full Text PDF]. Radiol Cardiothorac Imaging. 2019 Nov 21;1(5):e190050. doi: 10.1148/ryct.2019190050. eCollection 2019 Dec.
All that follows is from the above article:
Noninvasive fractional flow reserve derived from coronary CT angiography (FFRCT) is increasingly used in patients with coronary artery disease as a gatekeeper to the catheterization laboratory. While there is emerging evidence of the clinical benefit of FFRCT in patients with moderate coronary disease as determined with coronary CT angiography, there has been less focus on interpretation, reporting, and integration of FFRCT results into routine clinical practice. Because FFRCT analysis provides a plethora of information regarding pressure and flow across the entire coronary tree, standardized criteria on interpretation and reporting of the FFRCT analysis result are of crucial importance both in context of the clinical adoption and in future research. This report represents expert opinion and recommendation on a standardized FFRCT interpretation and reporting approach.
Keywords: Adults, CT-Angiography, Coronary Arteries, Fractional Flow Reserve, Heart
Published under a CC BY 4.0 license.
Expert opinion and recommendation was given by an independent group of physicians on a standardized interpretation and reporting approach for CT-derived fractional flow reserve testing supported by years of clinical experience.
Standardized criteria on interpretation and reporting of CT-derived fractional flow reserve (FFRCT) analysis results are of importance both in context of their clinical adoption and in future research.
Use of the FFRCT value 10–20 mm distal to the lower border of the stenosis for decision making is recommended.
We recommend for clinical decision making a dichotomous interpretation strategy to be considered only in lesions with FFRCT greater than 0.80 or lower than or equal to 0.75, whereas, in patients with FFRCT ranging between 0.76 and 0.80, additional risk stratification information is needed.
The results of FFRCT must be evaluated in their clinical context, taking into account patient symptoms, the coronary anatomy, and suitability of revascularization.