Standard and Ultrahigh Resolution Photon-Counting Coronary CTA–Derived FFR Against Invasive FFR Assessment

JACC. Cardiovascular imaging 2026 Open access

Read full text
Authors: Leonardo Portolan, Rafail A. Kotronias, Stefano Andreaggi, Alessandro Maino, Jason Walsh, Marios Antoniadis, Gautham Rao, Cheng Xie, Sheena Thomas, Kenneth Chan, Jeremy P. Langrish, Andrew Lucking
+10 more Jonathan Denton, Robyn Farrall, Nikant Sabharwal, David Holdsworth, Thomas Halborg, Stefan Neubauer, Adrian P. Banning, Keith M. Channon, Charalambos Antoniades, Giovanni Luigi De Maria
DOI: 10.1016/j.jcmg.2026.02.014
Cited by: 4
References: 20

Abstract

BACKGROUND: Coronary computed tomography angiography (CTA)-derived fractional flow reserve (FFR) serves as a gatekeeper to invasive coronary angiography (ICA), but its accuracy depends on image quality of the scan. Photon-counting coronary computed tomography angiography (PCCTA) technology enables spectral standard resolution (SR) and ultrahigh resolution (UHR) imaging. OBJECTIVES: This study aims to perform the first intraindividual comparison of SR-PCCTA-derived FFR, UHR-PCCTA-derived FFR, and invasive FFR. METHODS: Between February 2023 and April 2025, 32 patients with a clinical indication for ICA underwent research PCCTA with both SR and UHR acquisitions before ICA. Invasive FFR of intermediate coronary stenoses was measured. SR-PCCTA- and UHR-PCCTA-derived FFR were computed using an on-site, machine-learning-based prototype and compared with invasive FFR. Subanalyses were conducted in severely calcific and diffusely diseased vessels. Diagnostic accuracy for predicting invasive FFR

Fields of Study & Subjects

Cardiac Imaging and Diagnostics Advanced MRI Techniques and Applications Coronary Interventions and Diagnostics

Publication details

Journal / source
JACC. Cardiovascular imaging
Publisher
Elsevier BV
Volume
19
Issue
7
Pages
824–834
Publication date
23 March 2026
Language
EN