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Eur J Radiol2026;204113169.August 22, 2026Journal Article

CCTA characterization of coronary atherosclerosis diffuseness and focality using FFR-CT and plaque burden: results from the PRECISE trial.

Ruurt A Jukema1, Pamela S Douglas2, John K Khoo3, Maros Ferencik4, Nick Curzen5, Jonathan R Weir-McCall6, Gregg W Stone7, Campbell Rogers8, Sarah Mullen9, Nicholas Ng10, Benjamin J W Chow11, Mark G Rabbat12, Pal Maurovich-Horvat13, Gianluca Pontone14, Vincent L Sorrell15, Michelle Kelsey16, Michael G Nanna17, Sreekanth Vemulapalli18, Daniel B Mark19, Jonathon Leipsic20,
1Department of Radiology, St. Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada; Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands. Electronic address: r.jukema@amsterdamumc.nl.
2Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, United States. Electronic address: pamela.douglas@duke.edu.
3Department of Radiology, St. Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada; Dept of Cardiology, St George Hospital, Sydney, Australia. Electronic address: john.khoo@health.nsw.gov.au.
4Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, United States. Electronic address: ferencik@ohsu.edu.
5University of Southampton, Southampton, the United Kingdom of Great Britain and Northern Ireland. Electronic address: nick.curzen@uhs.nhs.uk.
6Biomedical Engineering and Imaging Sciences, King's College London, London, the United Kingdom of Great Britain and Northern Ireland. Electronic address: jonathan.weir-mccall@kcl.ac.uk.
7Icahn School of Medicine, Mount Sinai Medical Center, New York City, NY, United States. Electronic address: gregg.stone@mountsinai.org.
8Heartflow, Mountain View, CA, United States. Electronic address: crogers@heartflow.com.
9Heartflow, Mountain View, CA, United States. Electronic address: smullen@heartflow.com.
10Heartflow, Mountain View, CA, United States. Electronic address: nng@heartflow.com.
11Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. Electronic address: bchow@ottawaheart.ca.
12Division of Cardiology, Loyola University Chicago, United States. Electronic address: MRABBAT@lumc.edu.
13Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary. Electronic address: maurovich.horvat.pal@semmelweis.hu.
14Centro Cardiologico Monzino IRCCS, Milan, Italy; Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy. Electronic address: gianluca.pontone@cardiologicomonzino.it.
15Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY, United States. Electronic address: v.sorrell@uky.edu.
16DUKE University, Durham, NC, United States. Electronic address: michelle.kelsey@duke.edu.
17Yale University, New Haven, CT, United States. Electronic address: michael.nanna@yale.edu.
18DUKE University Medical Center, Chapel Hill, NC, United States. Electronic address: sreekanth.vemulapalli@duke.edu.
19Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, United States. Electronic address: daniel.mark@duke.edu.
20Department of Radiology, St. Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: jonathon.leipsic@ubc.ca.
PubMed DOI

Abstract

INTRODUCTION: Coronary artery disease (CAD) on coronary computed tomography angiography (CCTA) is typically assessed using a dichotomous ≥ 50 % stenosis threshold. However, CAD diffuseness may also influence patient management and outcomes. The PRECISE trial provides high quality data to examine these relationships. METHODS AND RESULTS: In this PRECISE substudy, patients with stable suspected CAD…

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