Abstract
Although ischemia should be evaluated before revascularization, stress myocardial perfusion imaging (MPI) is declining in Japan. On the other hand, computed tomography coronary angiography (CTCA) is increasing. Elective PCI increases in proportion to increase of CTCA. Fractional flow reserve (FFR) can also assess ischemia and identify the lesion for revascularization. FFR-guided revascularization improves prognosis, so FFR is increasingly used before PCI. However, elective PCI hardly decreases. FFR-CT can assess ischemia similar to FFR and correlated well with FFR. Therefore, the role of stress MPI as a gate keeper for CAG/PCI may be partially replaced by FFR-CT in the near future.