Evidence mapPaperPMID 42368293Full record

ReviewClinical Medicine Insights. Cardiology2026

Current State of Computed Tomography Derived Fractional Flow Reserve (FFR-CT) and Its Diagnostic Advantages.

Ibrahim Mortada, Dalton Buckingham, Aaron W Lee, Esosa Odigie-Okon, Mostafa Shalaby, Afaq Motiwala, Amer Abdulla, Michael C Boyars, Thomas A Blackwell, Hani Jneid

Abstract readReview
In one paragraph

Review in Clinical Medicine Insights. Cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ibrahim MortadaDepartment of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, TX, USA.ORCID https://orcid.org/0009-0006-9215-880X
Dalton BuckinghamJohn Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX, USA.
Aaron W LeeJohn Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX, USA.
Esosa Odigie-OkonDepartment of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, TX, USA.
Mostafa ShalabyDepartment of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, TX, USA.
Afaq MotiwalaDepartment of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, TX, USA.
Amer AbdullaDepartment of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, TX, USA.
Michael C BoyarsDepartment of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA.
Thomas A BlackwellDepartment of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA.
Hani JneidDepartment of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, TX, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Coronary computed tomography angiography (CCTA) is widely used for noninvasive evaluation of coronary artery disease (CAD) and is highly sensitive for detecting anatomic coronary stenosis with a high negative predictive value. However, CCTA is limited in its ability to determine the physiological significance of lesions, resulting in reduced specificity and disagreement with invasive coronary angiography in a substantial proportion of cases. Fractional Flow Reserve derived from CCTA (FFR-CT) was developed to address this anatomic-physiologic discordance by providing noninvasive, lesion-specific functional assessment of ischemia. This narrative review summarizes the current state of FFR-CT technology, its diagnostic performance relative to CCTA alone and invasive FFR, and its evolving role in contemporary CAD evaluation. Across prospective trials and meta-analyses, FFR-CT consistently improves diagnostic accuracy for ischemia-producing lesions, driven primarily by gains in specificity, with favorable agreement to invasive FFR at clinically relevant thresholds. Advances in computational modeling and machine learning have substantially reduced processing times, improving feasibility and workflow integration. Clinical studies demonstrate that incorporation of FFR-CT following CCTA improves selection for invasive coronary angiography, reduces unnecessary diagnostic catheterization, and provides prognostic information beyond anatomic disease burden alone. Important limitations remain, including dependence on CCTA image quality, reduced reliability in heavily calcified or complex coronary anatomy, and uncertainty near ischemic thresholds, necessitating careful interpretation within the clinical context. When applied selectively after high-quality CCTA, FFR-CT offers a robust noninvasive surrogate for invasive coronary physiology and supports a more targeted, physiology-guided diagnostic pathway for patients with suspected CAD.

Indexed as

coronary artery diseasecoronary CT angiographyFFR-CTfractional flow reserve

Identifiers

PMID42368293
PMCPMC13305830

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.