Fractional flow reserve in coronary computed tomography angiography: An expert consensus document of the society of cardiovascular computed tomography (SCCT) and the society for cardiovascular angiography and interventions (SCAI). Endorsed by the American college of cardiology (ACC)

Coronary CT Angiography (CCTA) is an established first line test in international chest pain guidelines, with clinical utilization growing rapidly.1–3 Despite its high accuracy for the detection of atherosclerosis and quantifying anatomical stenosis, there is often a discordance between anatomical severity and physiological flow restriction across a lesion, resulting in lower specificity in detecting flow limiting disease.4 CCTA derived fractional flow reserve (CT-FFR) estimates the physiological significance of a lesion using the anatomical data from the CCTA study, modelling the expected results obtained using pressure wire measured invasive fractional flow reserve (FFR) performed during invasive coronary angiography (ICA).