Noninvasive Functional Characterization of Coronary Plaques by Coronary Computed Tomography – Beyond the Morphology of Vulnerable Plaques

DOI: 10.2478/jim-2019-0022

Coronary computed tomography angiography (CCTA) is a reliable screening method of patients with coronary artery disease (CAD). CCTA is capable of both assessment of coronary stenosis and plaque morphology, but does not provides hemodynamic characterization of the coronary lesions. However the severity of coronary stenosis does not always reflect the hemodynamic significance of plaque. Invasive fractional flow reserve (FFR) is considered as gold standard for the functional evaluation of a potential ischemia-causing stenosis. FFR derived from CCTA (FFR-CT) is a new non-invasive diagnostic tool, using a typically acquired CCTA, without the need for any further radiation or medication. Additional functional assessment of the coronary lesions permit a more complex characterization of CAD patients. Based on the of FFR-CT examination, those patients who need invasive coronary intervention can be selected more precisely, and a more personalized and optimized treatment can be provided.