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. 2021 Oct 20;8:739633. doi: 10.3389/fcvm.2021.739633

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Copyright © 2021 Zhang, Han, Tan, Chai, Fam, Teo, Chin, Ong, Low, Chandola, Leng, Huang, Allen, Baskaran, Kassab, Low, Chan, Chan, Loh, Wong, Tan, Chua, Lim and Zhong.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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The sequential steps involved in the calculation of non-invasive fractional flow reserve (FFR) include (A) computed tomography coronary angiography (CTCA) image acquisition, (B) CTCA image segmentation via extracting centerlines and delineating lumen contours in the transversal and cross-sectional images, (C) 3D reconstruction of subject-specific coronary artery tree, and (D) using either analytical method to calculate FFR_AM (green box) or computational fluid dynamics simulation to compute FFR_B (blue box). In this case, FFR_AM and FFR_B were 0.79 and 0.75, respectively, at the site of invasive FFR 0.72 measured with a pressure catheter (right, inset) during invasive coronary angiography (yellow box).