FFRct

by HeartFlow  · Based in United States → — Redefining what's possible in coronary care.
Cardiology Radiology
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Regulatory Status Disclosed

Overview

HeartFlow FFRct Analysis is a non-invasive diagnostic tool that leverages advanced artificial intelligence (AI) and computational fluid dynamics (CFD) to provide a detailed understanding of coronary artery disease (CAD). It begins with a standard coronary CT angiogram (CCTA) and then uses these advanced technologies to create a personalized 3D digital model of the patient’s coronary arteries.

This detailed model allows physicians to analyze how blood flows through the vessels, pinpointing areas of narrowing or reduced blood flow (FFRct values) to provide a more accurate understanding of a patient’s heart health without invasive procedures. The HeartFlow FFRct Analysis integrates anatomical and physiological data, offering critical insights into the need for revascularization that were previously only available invasively.

The technology aims to improve diagnostic accuracy, guide treatment strategies, and potentially reduce the need for unnecessary invasive coronary angiographies.

Reviewed by Pouyan Golshani, MD — Interventional Radiologist

Key Features

  • Non-invasive diagnostic analysis of coronary arteries
  • Utilizes AI and computational fluid dynamics (CFD)
  • Generates personalized 3D digital models of coronary arteries
  • Analyzes blood flow and identifies areas of narrowing (FFRct values)
  • Integrates anatomical and physiological data from CCTA
  • Aids in diagnosing coronary artery disease (CAD)
  • Helps guide treatment strategies and revascularization decisions
  • Cloud-based processing of CCTA data
  • Provides color-coded 3D maps of heart arteries
  • Demonstrates high diagnostic performance

Use Cases

  • Diagnosing coronary artery disease (CAD) in symptomatic patients
  • Assessing patients with chest pain, shortness of breath, or other CAD symptoms
  • Evaluating patients with inconclusive or abnormal stress tests
  • Guiding treatment decisions for CAD (e.g., medical management, stents, bypass surgery)
  • Reducing the need for unnecessary invasive coronary angiographies (ICAs)
  • Risk stratification for future cardiac events like myocardial infarction

What Physicians Need to Know

Cardiac CT/MRI Analysis
Utilizes standard coronary CT angiogram (CCTA) images and advanced artificial intelligence (AI) with computational fluid dynamics (CFD) to create a personalized 3D digital model of the patient's coronary arteries. It simulates blood flow to assess the impact of blockages. The platform also includes Plaque Analysis for measuring total plaque volume and identifying plaque type (e.g., calcified or non-calcified), and Roadmap Analysis for visualizing and quantifying stenosis location and severity.
Heart Failure Risk Prediction
While not a direct heart failure prediction tool, lower FFRct values are associated with a higher risk of myocardial infarction (MI), cardiovascular mortality, and all-cause mortality, providing prognostic value for future cardiovascular events.
Coronary Artery Assessment
Provides non-invasive, functional (physiologic) information on coronary artery blood flow, identifying physiologically significant lesions and quantifying how much blockages limit blood flow to the heart muscle. It offers a detailed, color-coded 3D map of coronary arteries to help physicians determine vessel-by-vessel blood flow.
AHA/ACC Guideline Alignment
Recognized by the 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain with a Class of Recommendation 2a (Level of Evidence B) for diagnosing coronary artery disease (CAD) and guiding decision-making regarding revascularization, particularly for stenoses of 40-90%. Coronary CTA (CCTA) itself holds a Class 1 recommendation with Level A evidence.
Physician Tip

HeartFlow FFRct Analysis offers a comprehensive, non-invasive approach to evaluating coronary artery disease by combining anatomical and physiological insights from a single CCTA. This can significantly enhance diagnostic confidence, particularly for intermediate stenoses, and help guide appropriate treatment strategies, potentially reducing the need for unnecessary invasive coronary angiographies. The prognostic value of FFRct values aids in risk stratification and tailoring personalized care plans. Utilizing the integrated Plaque Analysis and Roadmap Analysis can further refine understanding of plaque burden and stenosis characteristics.

HeartFlow FFRct Analysis is designed for integration into standard reading environments such as Picture Archiving and Communication Systems (PACS) and supports Health Level Seven (HL7) for data exchange. The analysis is cloud-based and can be triggered on demand by the user. HeartFlow has established collaborations with major CT scanner manufacturers, including Siemens Healthineers and GE Healthcare, to facilitate seamless integration of FFRct analysis into existing cardiac CT workflows and protocols.

Details

Category Cardiology AI, Radiology & Imaging AI
Pricing Contact for pricing — CMS payment rate for FFRct Analysis: $1,017 (2025); Commercial payer rates vary.
DeploymentCloud-based (HeartFlow Network, AWS Cloud or Virtual Private Cloud), with a local Virtual Appliance for data transfer.
Compliance
BAA AvailableUnknown AI-estimated
HIPAA CompliantUnknown AI-estimated
FDA Status 1 AI-estimated

HeartFlow FFRct (v2.18) received FDA 510(k) clearance on December 6, 2018, as a coronary vascular physiologic simulation software device for quantitative and qualitative analysis of previously acquired CT DICOM data to aid in the assessment of coronary artery disease.
Integrations
EHR Not specified
Specialties Cardiology, Radiology

What the Web Says

HeartFlow FFRct is a non-invasive technology that creates a personalized 3D model of a patient's coronary arteries from a standard CT scan to assess blood flow and the impact of blockages. It aims to improve the diagnosis and management of coronary artery disease (CAD) by providing physiological information that traditional anatomical imaging alone may miss. The technology has received positive recommendations from health organizations like NICE due to its diagnostic accuracy, safety, and potential for cost savings by reducing unnecessary invasive procedures.

Overall: Positive

Strengths

  • High diagnostic accuracy for identifying obstructive coronary disease.
  • Reduces the need for unnecessary invasive coronary angiography (ICA).
  • Improved clinical outcomes, including a significant reduction in cardiovascular mortality.
  • Cost-effective, leading to potential healthcare savings.
  • Provides both anatomical and physiological information for better treatment planning.
  • Non-invasive and safe, with no additional radiation exposure beyond the initial CT scan.

Limitations

  • Diagnostic accuracy may decrease in patients with very high coronary calcium scores.
  • FFRct values are not provided for vessels with intracoronary stents.
  • Image quality challenges (e.g., motion artifacts, noise) can impact FFRct analysis.
  • Diagnostic accuracy can vary in the intermediate zone of stenosis.
  • Not all imaging centers that perform CCTA offer HeartFlow analysis.
  • Some studies suggest limited evidence for FFRct reducing ICA over and above CT-CA alone.

Based on reviews from: NICE, PMC, NCBI, News (HeartFlow, University Hospitals), Reddit, SourceForge, Scottish Health Technologies Group, G2, YouTube, Diagnostic and Interventional Cardiology, PLOS One

Last updated: 2026-07-19

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Press & Coverage

Quiver Quantitative
Heartflow, Inc. Announces New Analyses from FISH&CHIPS Study Highlighting Clinical and Economic Benefits of AI-Powered FFRCT Analysis for CAD
Heartflow announced significant findings from the FISH&CHIPS study, the largest analysis of FFRCT to date, involving over 90,000 patients in the NHS, demonstrating improved diagnostic decision-making, prediction of cardiovascular events, and substantial cost savings.
2025-12
Cardiovascular News
TCT 2024: Seven-year registry data confirm use of AI-enabled FFRCT - Cardiovascular News
HeartFlow presented seven-year data at TCT 2024, confirming the use of its AI-enabled FFRCT and Plaque Analysis in assessing long-term risk of coronary artery disease in stable, symptomatic patients.
2024-10
HeartFlow
Heartflow Announces New Reimbursement Code and Increased Payment for FFRCT
Heartflow announced that FFRCT transitioned to a Category I CPTu00ae code, effective January 1, 2024, supporting FFRCT as a standard of care and leading to increased payment for the service in hospital settings.
2024-01
HeartFlow
Heartflow Announces Publication of 10-year Follow-Up Data from the DISCOVER-FLOW Study in the Journal of Cardiovascular Computed Tomography
Heartflow announced the publication of 10-year follow-up data from its DISCOVER-FLOW study in the Journal of Cardiovascular Computed Tomography, demonstrating that its non-invasive AI-driven FFRCT predicts patient outcomes as effectively as invasive FFR.
2024-03
HeartFlow
Heartflow Announces Revolutionary Five-Year Data Demonstrating a 63 Percent Mortality Reduction with FFRCT-Guided Care in PAD Patients
A study published in the Journal of Vascular Surgery revealed that coronary CTA with FFRCT care significantly reduces mortality by over 60 percent at five years in patients with PAD undergoing major vascular surgery.
2024-05
HeartFlow
New Analysis Published in Nature Medicine Demonstrates Advantages of Nationwide Coronary CTA Strategy with Heartflow FFRCT in Over 90000 Patients with Coronary Artery Disease
Two-year data from the FISH&CHIPS study, published in Nature Medicine, showed improved care efficiency and a reduction in unnecessary invasive and noninvasive cardiac tests when using CCTA and Heartflow FFRCT versus CCTA alone.
2025-05
Open Heart
Prognostic value of CT-derived fractional flow reserve for major adverse cardiovascular events in patients with suspected or known coronary artery disease: a systematic review and meta-analysis
A systematic review and meta-analysis of 22 studies with over 20,000 patients found that FFR-CT u22640.80 was associated with a significantly higher risk of major adverse cardiovascular events, with consistent results across different FFR-CT technologies.
2026-05
Medgadget
FDA Approves HeartFlow FFR-CT: Non-Invasive Method for Determining Coronary Ischemia
The U.S. Food and Drug Administration approved HeartFlow's FFRCT software in 2014, allowing non-invasive evaluation of blood flow in coronary arteries for patients with suspected coronary artery disease.
2014-11

Videos

Product demos, reviews, and walkthroughs for FFRct.

View all on YouTube

Frequently Asked Questions

AI-powered FFRct typically involves sending standard coronary CT angiography (CCTA) images to a cloud-based platform for analysis. The AI algorithm processes these images to generate a patient-specific 3D model and calculate FFR values, which are then returned as a report to aid in diagnostic decision-making. This integration aims to provide non-invasive functional assessment without requiring additional invasive procedures.
FFRct platforms have received regulatory clearances, such as from the FDA, which necessitates rigorous validation of their AI algorithms for accuracy and reliability. Physicians must ensure compliance with data privacy regulations like HIPAA when transmitting patient CCTA data to third-party AI services, often through secure, de-identified channels. Understanding the AI's validation studies and ongoing performance monitoring is crucial for responsible use.
Established alternatives include invasive coronary angiography with pressure wire-derived FFR, stress echocardiography, cardiac MRI, and nuclear stress testing. These might be preferred when CCTA quality is suboptimal, there's a high pre-test probability of severe disease requiring immediate intervention, or when a direct invasive assessment is clinically indicated. FFRct aims to reduce unnecessary invasive procedures.
Pricing for FFRct services often involves a per-case fee charged by the vendor to the healthcare institution, which is then billed to the patient's insurance. While costs vary, FFRct generally aims to be more cost-effective than invasive FFR procedures by avoiding catheterization lab time and associated risks, though it adds to the cost of the initial CCTA. Studies suggest FFRct can lead to significant cost reductions compared to invasive strategies.
Limitations of FFRct include its dependence on high-quality CCTA images, potential inaccuracies in cases of severe calcification or motion artifact, and the fact that it's a computational model, not a direct physiological measurement. While AI algorithms are validated, concerns can arise regarding their generalizability to extremely diverse patient populations not fully represented in training datasets, potentially leading to varied performance in specific subgroups. FFRct should not be used for patients with unstable coronary syndromes or when urgent workup is critical.
FFRct aims to improve patient management by providing non-invasive functional assessment, potentially reducing the need for unnecessary invasive angiography and revascularization procedures in patients with anatomically significant but functionally non-significant lesions. Studies indicate it can lead to more appropriate referral for invasive procedures, optimizing resource utilization and potentially improving patient outcomes by guiding more precise treatment decisions and reducing adverse cardiac events.
Physicians, particularly cardiologists and radiologists, need to understand the principles behind FFRct, its technical capabilities, and its limitations. While AI generates FFR values, interpreting the comprehensive report, understanding the 3D anatomical context, and integrating these findings with the patient's overall clinical picture requires specialized knowledge in cardiac imaging and coronary artery disease management. Training programs and CME events are available to facilitate learning and best practices for interpretation and reporting.

Compare FFRct

VS
FFRct vs EchoNext
Cardiology AI Adjacent · 65/100
Both FFRct and EchoNext are AI-powered diagnostic tools in cardiology, but they differ in their primary focus and input data. FFRct analyzes CCTA scans to create 3D models…
VS
FFRct vs PMcardio
Cardiology AI Adjacent · 60/100
Both FFRct and PMcardio are AI-powered cardiology tools, but they focus on different diagnostic modalities. FFRct analyzes CCTA scans to create 3D models for coronary artery disease diagnosis,…
VS
FFRct vs Reveal LINQ Insertable Cardiac Monitor
Cardiology AI Adjacent · 60/100
These tools are adjacent in their application within cardiology, but serve distinct purposes. HeartFlow FFRct is a diagnostic tool that uses AI to analyze CCTA scans for coronary…
VS
SENSICARDIAC MOBI DIAGNOSTIC HEART MURMUR APPLICATION vs FFRct
Cardiology AI Adjacent · 60/100
Tool A assists in the diagnosis of heart murmurs by analyzing acoustic heart signals, providing decision support for initial cardiac assessments. In contrast, Tool B focuses on diagnosing…

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Suggest an Edit → | Last Verified: 2026-04-18 | First Added: 2026-04-18

Investors who backed FFRct

Funded through the company that built this tool.

USVP US Venture Partners
VC T1
Menlo Park, United States
$5M-$25M
U.S. Venture Partners, known as USVP, is a Menlo Park-based early-stage venture firm with a multi-decade history of leading Series A rounds…
Biotech Care Delivery / Tech-Enabled Services
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