Standard and Ultrahigh Resolution Photon-Counting Coronary Computed Tomography Angiography (CTA)–Derived Fractional Flow Reserve (FFR) Against Invasive FFR Assessment
Authors' conclusion
Both SR-PCCTA- and UHR-PCCTA-derived FFR correlated with invasive FFR, but UHR-PCCTA outperformed SR-PCCTA in diagnostic accuracy and hemodynamic significance classification.
Study context
- Population
- Patients with a clinical indication for invasive coronary angiography (ICA), intermediate coronary stenoses, February 2023–April 2025
- Participants
- 32 patients54 vessels
- Comparison
- UHR-PCCTA-derived FFR vs SR-PCCTA-derived FFR, against invasive FFR
- Outcome
- Diagnostic accuracy for predicting invasive FFR <0.80 and concordance in hemodynamic significance classification (<0.80, ≥0.80)
Methodological detailsintraindividual comparison
- Intraindividual comparison
Performance
As reported in the abstract
Diagnostic accuracy and agreement with invasive FFR
| Test or model | AUC | Cohen's κ | Correlation ρ |
|---|---|---|---|
| SR-PCCTA | 0.80 | 0.50 | 0.490; P < 0.001 |
| UHR-PCCTA | 0.93 | 0.70 | 0.728; P < 0.001 |
AUC
SR-PCCTA0.80
UHR-PCCTA0.93
Cohen's κ
SR-PCCTA0.50
UHR-PCCTA0.70
Correlation ρ
SR-PCCTA0.490; P < 0.001
UHR-PCCTA0.728; P < 0.001
- UHR-PCCTA vs SR-PCCTA: P for comparison = 0.012 — 0.93 vs 0.80
Further findings
| Outcome | UHR-PCCTA |
|---|---|
| Correlation with invasive FFR in severely calcific and diffusely diseased vessels (subanalyses) | |
| Severely calcific ρ | 0.577; P = 0.039 |
| Diffusely diseased ρ | 0.772; P = 0.009 |
Correlation with invasive FFR in severely calcific and diffusely diseased vessels (subanalyses)
- Unlike SR-PCCTA, UHR-PCCTA-derived FFR maintained its correlation
Original publication
Standard and Ultrahigh Resolution Photon-Counting Coronary CTA–Derived FFR Against Invasive FFR Assessment. JACC Cardiovasc Imaging. Published 23 March 2026. doi:10.
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