CT-FFR: Wie eine neue Technologie die kardiovaskuläre Diagnostik transformieren könnte

Zusammenfassung

Hintergrund

Die CT-basierte fraktionelle Flussreserve (CT-FFR) ist eine vielversprechende nicht-invasive Methode zur funktionellen Beurteilung von Koronarstenosen. Sie erweitert die diagnostischen Möglichkeiten der Koronaren CT-Angiografie (cCTA), indem sie hämodynamische Informationen liefert und potenziell unnötige invasive Koronarangiografien reduziert.

Methode

Dieser Übersichtsartikel fasst aktuelle technologische Entwicklungen, Studienergebnisse und klinische Anwendungen der CT-FFR zusammen. Zudem werden die Vor- und Nachteile verschiedener Softwarelösungen, darunter auf künstlicher Intelligenz (KI) basierende On-Site-Analysen, sowie deren potenzielle Integration in die klinische Routine diskutiert.

Ergebnisse

Studien zeigen, dass die CT-FFR die diagnostische Genauigkeit im Vergleich zur cCTA verbessert und das Patientenmanagement optimieren kann. Fortschritte in der künstlichen Intelligenz und neue bildgebende Verfahren wie die Photon-Counting-CT könnten die CT-FFR weiter verfeinern und ihre Anwendbarkeit erweitern. Trotz vielversprechender Ergebnisse besteht weiterhin Forschungsbedarf hinsichtlich Langzeitvalidierung, standardisierter Workflows und wirtschaftlicher Machbarkeit.

Schlussfolgerung

Die CT-FFR ist ein vielversprechendes ergänzendes Tool zur Beurteilung der hämodynamischen Relevanz von Koronarstenosen. Insbesondere bei komplexen, langstreckigen oder konsekutiven Stenosen ist die CT-FFR hilfreich, weil eine rein anatomische, visuelle Betrachtung nicht immer ausreicht. Die Kombination aus technischen Innovationen und KI-gestützter Bildanalyse könnte das Potenzial haben, die nicht-invasive Koronardiagnostik nachhaltig zu verändern.

Kernaussagen

• Die CT-FFR steigert die Spezifität und diagnostische Genauigkeit im Vergleich zur cCTA allein.

• Technologische Fortschritte könnten die CT-FFR weiter verfeinern und ihre Anwendbarkeit erweitern.

• Die zunehmende Verbreitung und verbesserte Anwendbarkeit der CT-FFR im klinischen Alltag ist vielversprechend.

Zitierweise

• Kloth C, Brendel JM, Kübler J et al. CT-FFR: How a new technology could transform cardiovascular diagnostic imaging. Rofo 2025; DOI 10.1055/a-2697-5413

• References

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