Computed Tomography Fractional Flow Reserve (CT-FFR) for assessing functionally significant coronary artery stenosis
Evidence Overview
Background
- AI-estimated CT‑FFR showed good agreement with results from invasive fractional flow reserve (FFR) measurement for assessing functionally significant coronary artery stenosis. The use of non-invasive AI-estimated CT-FFR could avoid the need for invasive FFR in some patients.
- Based on an indirect comparison using invasive FFR as a reference, AI-estimated CT-FFR has similar specificity to conventional non-invasive calculation of CT-FFR using
computational fluid dynamics (CFD). This means that the two non-invasive techniques (AI- and CFD-estimated CT-FFR) appear to have a similar ability to rule out clinically important coronary artery stenosis. - There remains substantial uncertainty about the diagnostic performance of AI-estimated CT-FFR because of variation in the definitions of AI that were used in the literature and how individual studies were conducted.
- No studies have looked at what happens after an AI-estimated CT-FFR test, for example, whether people also had invasive tests, experienced side effects, had better health outcomes or how patients felt about their care. This means that we do not yet know what the overall impact of AI-estimated CT‑FFR would be for patients or the health service.
- No studies assessed whether adding CT‑FFR to standard CT coronary angiography (CT-CA) provided added value for patient diagnosis compared with CT-CA alone.
- There were no economic studies looking at the costs or cost-effectiveness of using AI-estimated CT-FFR, so we cannot say whether it would offer value for money for the
health service.
IMTO
Cardiovascular System
20 May 2026
The Accelerated National Innovation Adoption (ANIA) collaborative
