Coronary disease & ACSDiagnostic or prognostic study

Standard and Ultrahigh Resolution Photon-Counting Coronary Computed Tomography Angiography (CTA)–Derived Fractional Flow Reserve (FFR) Against Invasive FFR Assessment

JACC Cardiovasc ImagingPublished

  • Diagnostic accuracy study
  • intraindividual comparison

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 patients · 54 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)

Performance

As reported in the abstract

Diagnostic accuracy and agreement with invasive FFR
Test or modelAUCCohen's κCorrelation ρ
SR-PCCTA0.800.500.490; P < 0.001
UHR-PCCTA0.930.700.728; P < 0.001
  • UHR-PCCTA vs SR-PCCTA: P for comparison = 0.012 — 0.93 vs 0.80

Further findings

OutcomeSR-PCCTAUHR-PCCTAInvasive FFR
Correlation with invasive FFR in severely calcific and diffusely diseased vessels (subanalyses)
Severely calcific ρNot reported in the abstract0.577; P = 0.039Not reported in the abstract
Diffusely diseased ρNot reported in the abstract0.772; P = 0.009Not reported in the abstract

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:10.1016/j.jcmg.2026.02.014

Summarised from the published abstract; every number is checked against it