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Comprehensive noninvasive anatomical and functional imaging would be desirable to identify patients who are likely to benefit from invasive coronary angiography and revascularisation. Advances in computational technology now permit calculation of FFR using resting CCTA, RA or QCA image data, without the need for additional radiation or medication. Early data from various studies demonstrate improved accuracy and a discriminatory ability of FFRCT to identify ischaemia-producing lesions compared with CCTA alone. FFR estimation from RA provides a less invasive alternative to conventional FFR measurement which is not widely applied yet, however early results are promising. Computation of FFRQCA allows safe and efficient assessment of the functional significance of intermediate stenosis. Acknowledging the various limitations of each technique, these combined anatomic–functional assessments have the potential to simplify the noninvasive diagnosis of coronary artery disease with a single study to identify patients with ischaemia-causing stenosis who may benefit from revascularisation.

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