Multimodal CT for Precision Diagnosis of Coronary Artery Disease: Integrating Anatomical and Functional Imaging

Abstract

Precision diagnosis of coronary artery disease (CAD) requires the integration of multidimensional data, including coronary anatomy and physiological function, for a comprehensive evaluation. This article reviews recent advances in multimodal computed tomography (CT) technologies for diagnosing CAD, analyzing their complementary strengths and limitations. In anatomical imaging, coronary computed tomography angiography (CCTA) assesses the degree of coronary stenosis and plaque characteristics but has limited specificity in evaluating functional ischemia. Functional imaging methods, such as fractional flow reserve derived from CT (CT-FFR), which simulates coronary pressure changes using fluid dynamics, and computed tomography perfusion (CTP) for myocardial ischemia detection, significantly enhance the accuracy and reliability of functional evaluations in CAD. The synergistic use of multimodal CT technologies addresses the limitations inherent to single imaging modalities, reduces unnecessary invasive procedures, and optimizes revascularization decisions, facilitating hierarchical precision assessment from anatomical stenosis to functional ischemia.