Fractional Flow Reserve Derived from Coronary CTA

A description of the scientific principles, clinical validation, and implementation of fractional flow reserve derived from standard coronary CT angiography.

Course ID: Q00565 Category:
Modalities: , ,


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Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Cardiac-Interventional Radiography: 1.50
Procedures: 1.50
Hemodynamics, Calculations, and Percutaneous Intervention: 1.50

Computed Tomography: 1.00
Procedures: 1.00
Neck and Chest: 1.00

Nuclear Medicine Technology: 1.00
Procedures: 1.00
Cardiac Procedures: 1.00

Registered Radiologist Assistant: 3.00
Procedures: 3.00
Thoracic Section: 3.00


  1. Introduction
  2. Invasive FFR Determination
  3. Noninvasive Modalities for the Functional Evaluation of CAD
  4. Noninvasive FFRCT
  5. Current Evidence
    1. Diagnostic Accuracy and Validation
    2. Intermediate Stenosis
    3. Calcification
  6. Clinical Implications
    1. Impact on Patient Care
    2. Treatment Planning Based on Virtual Stent Placement
    3. Cost-effectiveness and Quality of Life
    4. Contextualization and Comparison of FFRCT with Other Noninvasive Functional Tests
  7. Limitations
  8. Future Outlook and Conclusion


Upon completion of this course, students will:

  1. identify the reference standard technique for diagnosis of CAD
  2. understand the outcomes related to FFR values
  3. be familiar with how invasive FFR measurements are determined
  4. identify the methods of administrating vasodilators during FFR
  5. be familiar with the use of FFR-informed treatment decision making
  6. be familiar with the reasons FFR may be underutilized
  7. be familiar with MPI SPECT imaging
  8. identify the limitations of MPI SPECT imaging
  9. identify the limitations of MR cardiac imaging
  10. be familiar with the evolution of CT angiography
  11. be familiar with current CT imaging techniques for myocardial perfusion
  12. be familiar with TAG
  13. be familiar with correction models when using TAG
  14. be familiar with the diagnostic accuracy of TAG
  15. be familiar with the computation of fractional myocardial mass
  16. identify the study on the diagnostic performance of fractional myocardial mass
  17. be familiar with postprocessing techniques used in FFRCT
  18. identify the factors that make FFRCT possible
  19. identify the equations used to calculate FFRCT values
  20. identify the models to overcome the limitations of 3D models when calculating FFRCT
  21. be familiar with the deep learning algorithm
  22. be familiar with the DISCOVER-FLOW trial
  23. be familiar with the findings in the DISCOVER-FLOW trial
  24. be familiar with the DeFACTO trial
  25. understand the outcomes of the DeFACTO trial
  26. be familiar with the details surrounding the NXT trial
  27. be familiar with the improvement in accuracy when using FFRCT
  28. be familiar with the meta-analysis study conducted on FFRCT
  29. identify the outcomes of the NXT trial to reclassify patients correctly
  30. be familiar with the impact of workstation-based FFRCT on intermediate stenosis
  31. be familiar with the impact of coronary calcification on FFRCT calculations
  32. be familiar with impact FFRCT can have on patient care
  33. understand the impact FFRCT can have on reducing unnecessary ICA procedures
  34. be familiar with the outcomes of the RIPCORD trial
  35. understand the impact FFRCT can have on treatment strategy
  36. be familiar with the utility and impact of FFRCT on decision making and down stream testing
  37. identify the study conducted that demonstrated the utility of FFRCT to predict the functional outcome of percutaneous coronary intervention
  38. be familiar with research that is focusing on comparing FFRCT with other noninvasive diagnostic tests
  39. be familiar with the limitations of FFRCT
  40. be familiar with the advantages of FFRCT as a single noninvasive test