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Advances in non-invasive cardiac CT angiography for the diagnosis
of coronary artery disease: Two functional approaches in comparison

Dear readers,

Which functional technique should be applied to non-invasive cardiac CT angiography to obtain the most accurate and reliable diagnosis of coronary artery disease? Prof. Loewe will be answering this question in this month’s review which provides a careful analysis of the pros and cons of CT myocardial perfusion imaging and CT-derived fractional flow reserve, before eventually presenting us with a very interesting and promising conclusion. 

The properties and limitations of these imaging techniques are also illustrated in the two selected articles proposed in this Newsletter: a retrospective analysis and a review, respectively, that evaluate and compare the current evidence on their diagnostic performance.

Finally, the three clinical cases selected from the archive highlight the capability of coronary CT angiography and of contrast enhancement in identifying coronary artery defects and severe stenosis in daily practice.

We remind you that suggestions for topics to be covered in future issues of this newsletter are welcomed. Please send your proposals to us at

From the team



Statement regarding functional cardiac CT (FFR or perfusion)
C. Loewe
During the last few decades, modern cardiac CT has shown a tremendous technical advancement which has led to a significant improvement of temporal as well as spatial resolution. However, despite these efforts, the focus on “morphology-only” remains one of the major drawbacks of cardiac CT when compared to invasive coronary angiography. Recent developments have now made it possible to obtain even functional information by way of non-invasive cardiac CT.
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Fukuoka R, Kawasaki T, Umeji K et al. The diagnostic performance of on-site workstation-based computed tomography-derived fractional flow reserve. Comparison with myocardium perfusion imaging. Heart Vessels. 2021 Jul 14. doi: 10.1007/s00380-021-01897-w.

Yang YT, Xu PP, Zhou F et al. Coronary computed tomography angiography derived flow fractional reserve: the state of the art. Chin J Acad Radiol. 2020;3:84-93.