A 3D image of a patient’s coronary arteries. Photo: University Hospital Southampton NHS Foundation Trust

Doctors are using a new tool to create a 3D image of a patient’s coronary arteries in a “pioneering” technique to diagnose and manage heart disease.

The technology, known as fractional flow reserve computed tomography (FFRCT), developed by US company HeartFlow, creates a detailed 3D model of a patient’s coronary arteries from a standard CT scan image.

It then uses complex calculations to work out the extent of blockages in the coronary arteries and if they are restricting the flow of blood – all without the need for invasive intervention.

Nick Curzen, a consultant cardiologist at Southampton General Hospital, said the system could become the default method for the initial assessment of patients with chest pain after he presented a study that showed it changed treatment plans in more than a third of cases.

Coronary heart disease, also known as coronary artery disease, develops when a build-up of fatty substances silts up or blocks the blood supply to the heart. It is the most common cause of angina – chest pain – and heart attacks and is responsible for 73,000 deaths in the UK every year.

Currently, most patients presenting with angina end up having an angiogram, in which thin plastic tubes are passed from an artery in the wrist to the heart so that dye can be injected down the coronary arteries under an X-ray camera.

However, in a study presented at the European Association of Percutaneous Cardiovascular Interventions (EuroPCR) congress, Curzen and his colleagues found that using the new computer technology added “significant” detail to standard CT scans of patients who presented with angina.

This enabled the clinicians to make improvements in diagnosis and management without the use of an invasive angiogram X-ray and pressure wire.

Curzen said: “This study demonstrates that the non-invasive FFRCT analysis from a standard coronary CT scan has the potential to become the default method for the initial assessment of many patients with cardiac-sounding chest pain by assessing both the coronary anatomy and physiology simultaneously.

“This has important implications for our clinical practice and could redefine conventional care pathways.”