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2341], 'lesion': [728], 'confirmed': [730], 'by': [731, 1559, 2015, 2026, 2702, 4338], 'cardiac': [732, 1507, 1653, 1917, 2237, 2329, 2467, 3027, 3467, 3846], 'catheterization': [733], '(D).CCTA': [734], 'has': [735, 830, 871, 1151, 1463, 1912], 'early': [738], 'stages': [739], 'clinical': [741, 787, 799, 1101, 1708, 1931, 2032, 4030], 'evaluation': [742, 2373, 2572, 2653], 'matured': [744, 1913], 'into': [745, 798, 1798, 1914], 'robust': [747, 1164, 1916], 'diagnostic': [748, 762, 1286, 2119, 2234, 2288, 3090, 4016], 'technique': [749, 838, 860], 'both': [751, 1624], 'elective': [752], 'emergent': [754], 'settings.': [755], 'Technological': [756], 'innovations': [757], 'are': [758, 1050, 1128, 1193, 1329, 1554, 1692, 1764], 'continuously': [759], 'improving': [760], 'performance': [763, 2289, 2318, 3091], 'decreasing': [765], 'associated': [769], 'this': [771, 774, 1521, 1523, 1701, 1844, 1973, 2008], 'test.': [772], 'In': [773, 1062], 'Clinician': [775], 'Update,': [776], 'we': [777], 'provide': [778, 1815, 1824], 'an': [779, 858, 1039, 1669, 3369], 'updated': [780], 'summary': [781], 'on': [782, 1146, 1183, 1327, 1414, 1478, 1618, 1681, 1826, 1830, 2030, 2259, 2273, 2800, 3629, 4112], 'state-of-': [784], 'the-art': [785], 'use': [788, 1185, 1313, 1416, 1460, 1683, 1702, 1939], 'CCTA.Technical': [790], 'Developments': [791], 'Radiation': [793, 1110, 2260, 3281], 'ExposureThe': [794], 'integration': [795], 'practice': [800, 1932], 'can': [801, 843, 897, 1240, 1822], 'predominantly': [802, 1194], 'be': [803, 1055, 1060, 1467, 1540, 2012], 'attributed': [804], 'substantial': [806, 1408, 1511, 1695], 'technical': [807, 1856], 'developments': [808], 'over': [809, 1026, 1032, 1155], 'last': [811, 1157], 'years,': [812], 'which': [813, 865, 879, 927, 1070, 1840, 2035], 'have': [814, 1902], 'enabled': [815], 'shorter': [816], 'scan': [817], 'times,': [818], 'higher': [819, 1046], 'temporal': [820, 952], 'spatial': [822], 'resolution,': [823], 'lower': [825, 988], 'requirements.': [827], 'Conventionally,': [828], 'been': [831, 1152, 1464], 'using': [833, 980, 1210, 2162, 2324, 3014, 3368], 'retrospective': [834], 'ECG': [835], 'gating.': [836], 'This': [837, 869, 1000, 1308], 'applies': [839, 866], 'continuous': [840], 'involve': [844], 'levels': [846, 1047], '10': [848], '20': [850, 1033], 'mSv.1': [851], 'More': [852], 'recently,': [853], 'prospective': [854], 'EKG-triggering': [855], 'rediscovered,': [857], 'old': [859], 'gleaned': [861], 'from': [862, 887, 922, 941, 993, 1042, 1175, 1196, 1255, 1373, 1583, 1899, 2049, 2198, 2233, 2262, 2271, 2798, 2926, 3102], 'electron-beam': [863], 'CT,': [864, 3129, 3211], 'discontinuously.': [868], 'approach': [870], 'mean': [873], '≈3.5': [877], 'mSv,1': [878], 'comparable': [881], 'annual': [884], 'background': [885], 'natural': [888], 'sources.': [889], 'most': [891, 1964], 'current': [892, 1168, 1278, 1998], 'class': [893], 'instruments': [896], 'image': [898, 946, 968, 2121], 'entire': [900], 'heart': [901, 974, 2862, 3022], 'within': [902, 986], 'beat': [905], '<1': [911], 'mSv2': [912], 'patients': [914, 1010, 1189, 1289, 1354, 1442, 1488, 1531, 1656, 2375, 2474, 2511, 2832, 3020, 3729], 'slow': [916], 'sinus-rhythm.': [917], 'Further': [918], 'reduction': [919], 'expected': [921, 1096], 'novel': [923, 4167], 'iterative': [924], 'reconstruction': [925], 'techniques,': [926], 'also': [928, 1008], 'address': [929, 1997], 'some': [930], 'traditional': [933], 'limitations': [934], 'CCTA,': [936, 1396, 1606], 'such': [937, 1044], 'as': [938, 1346, 1846, 2738, 3722], 'artifacts': [940], 'heavy': [942], 'calcifications': [943], 'high': [945, 971, 1921, 2476, 3362], 'noise': [947], 'obese': [949], 'patients.': [950], 'Enhanced': [951], 'resolution': [953], 'data': [955], 'postprocessing': [956], 'algorithms': [957], 'more': [959, 1104, 1270, 1445, 1639, 1816, 1867], 'recent': [960], 'scanner': [961], 'classes': [962], 'furthermore': [963], 'improve': [964], 'robustness': [966], 'acquisition': [969, 982], 'vis-à-vis': [970], 'irregular': [973], 'rates.Figure': [975], '3': [976, 1027], 'shows': [977], 'that': [978, 1238, 1259], 'contemporary': [981, 1966, 3472], 'methods': [983], 'now': [984], 'falls': [985], 'range': [989, 1068], 'doses': [992], 'disease': [996, 1835, 2749], '(CAD)': [997], 'tests.': [999], 'consideration': [1003, 1081], '1-time': [1005], 'testing': [1006, 1561], 'who': [1011], 'undergo': [1012], 'various': [1016, 1803], 'modalities': [1017, 2023], 'typical': [1020], 'cumulative': [1021], '16': [1024], 'mSv': [1025, 1031, 2161], '64': [1030], 'years.4': [1034], 'However,': [1035, 1336], 'importantly,': [1036, 1640], 'risks': [1037], 'across': [1038], 'adult': [1040], 'population': [1041, 1517], 'even': [1043], 'comparatively': [1045], 'likely': [1051, 1078, 2011], 'too': [1052], 'low': [1053, 1214, 1294, 1494, 3360], 'epidemiologically': [1056], 'detectable': [1057], 'may': [1059, 1814], 'nonexistent.5': [1061], 'age': [1067], 'CAD': [1071, 1252, 1261, 1297, 1497, 1637, 1799, 1827, 1967, 2003], 'concern,': [1074], 'risk': [1076, 1687, 1819], 'minor': [1080], 'decision': [1084, 2471], 'proceed': [1086], 'imaging,': [1088, 3971, 4260], 'although': [1089, 1469], 'appropriateness': [1091], 'indication': [1093, 1309, 1524], 'benefit': [1097], 'specific': [1100, 1677, 2031], 'scenario': [1102], 'deserve': [1103], 'careful': [1105], 'weighing.Download': [1106], '3.': [1109], 'comparison': [1112, 2106, 4032], 'different': [1114], 'tests': [1116], 'CAD.': [1118, 1870], 'average': [1120], 'effective': [1121, 1965], 'equivalents': [1124], 'each': [1126], 'procedure': [1127], 'shown.1–4': [1129], 'angiography;': [1134, 1391, 1399, 1601, 1609], 'FGD-PET,': [1135], 'Fluorodeoxyglucose': [1136], 'Positron': [1137], 'Emission': [1138], 'Tomography;': [1139], 'Tc,': [1140], 'Technetium;': [1141], 'TI,': [1142], 'Thallium.Evidence': [1143], 'Guidelines': [1145], 'CCTAThe': [1147], 'efficacy': [1148, 1176, 1203, 1922], 'exhaustively': [1153], 'demonstrated': [1154], 'decade.': [1158], 'As': [1159], 'consequence': [1161], 'low-risk': [1166], 'technology,': [1167], 'studies': [1169, 1209, 1901], 'extend': [1170], 'value': [1172, 1234, 1621, 2696, 3507, 3716, 4203], 'effectiveness.Stable': [1178], 'Chest': [1179, 1405, 1736, 2622, 2766], 'Pain': [1180, 1406, 1737, 2623, 2767], 'SyndromeCurrent': [1181], 'guidelines': [1182, 1936], 'stable': [1191, 1291, 1370, 1627, 1776, 1941, 3728], 'angina': [1192, 1292], 'derived': [1195, 3406], 'favorable': [1198, 1671], 'results': [1199, 1246], 'initial': [1202, 1910, 4163], 'trials.': [1204, 1709], 'A': [1205, 2961, 3118, 3150, 3270, 3421, 3614, 3773, 3782, 3961, 4117, 4242, 4442], 'systematic': [1206, 2658, 2690], 'analysis': [1207, 3007], 'regular': [1211], 'revealed': [1218], 'pooled': [1220], 'sensitivity': [1221], 'specificity': [1223, 1475], '98%': [1227], '89%,': [1229], 'respectively.': [1230], 'negative': [1232, 1504], 'predictive': [1233, 2695], 'approximates': [1235], '100%,': [1236], 'indicating': [1237], 'safely': [1241], 'exclude': [1242], 'CAD.6': [1244], 'These': [1245], 'compare': [1247], 'favorably': [1248], 'alternative': [1250, 2021], 'noninvasive': [1251, 1977, 2320], 'tests.7Findings': [1254], 'cost-effectiveness': [1256], 'analyses': [1257], 'indicate': [1258], 'pretest': [1262], 'probabilities': [1263], '10%': [1265], '50%,': [1267], 'cost-effective': [1271], 'than': [1272, 1448], 'other': [1273, 2062], 'modalities.8As': [1275], 'result,': [1277], 'Appropriate': [1279, 2404], 'Use': [1280, 2405], 'Criteria9': [1281], 'recommend': [1282, 1937], 'work-up': [1287, 1558], 'but': [1293, 2024], 'intermediate': [1296, 1496], 'likelihood,': [1298], 'especially': [1299], 'setting': [1302, 1368, 1421, 1577], 'equivocal': [1304, 1506], 'prior': [1305], 'results.': [1307], 'chiefly': [1310], 'encompasses': [1311], 'clarifying': [1317], 'abnormal': [1318], 'findings': [1319, 1326], 'at': [1320, 1340, 1647, 4025, 4514], 'functional': [1321, 1560], 'testing.': [1322], 'Subjects': [1323, 1545], 'significant': [1325, 1552], 'referred': [1330, 1555], 'catheter': [1332, 1390, 1563, 1600, 1851], '4).': [1335], 'increasing': [1337, 1616], 'efforts': [1338], 'aim': [1339], 'defining': [1341], 'role': [1343, 3678], 'primary': [1348, 1848], 'gate-keeper': [1349], 'management': [1352, 1364, 1573, 1774, 1968], 'suspected': [1356, 3737], 'CAD.11Download': [1357], '4.': [1360], 'Suggested': [1361, 1570], 'CCTA-based': [1362, 1426, 1571], 'algorithm': [1365, 1574], 'angina.': [1371], 'Modified': [1372, 1582], 'de': [1374, 2414], 'Feyter': [1375, 2415], 'Nieman10': [1377], 'permission': [1379, 1589], 'publisher.': [1382, 1592], 'Copyright': [1383, 1593], '©': [1384, 1594, 4606], '2012,': [1385], 'Oxford': [1386], 'Journals.': [1387], 'CA': [1388, 1598], 'CAD,': [1392, 1602, 1666], 'disease;': [1395, 1605], 'FFR,': [1401], 'fractional': [1402, 1896, 2923, 3098, 4152, 4158, 4215, 4522], 'flow': [1403, 1897, 2924, 3099, 4153, 4159, 4216, 4523], 'reserve.Acute': [1404], 'SyndromeA': [1407], 'emerging': [1413, 1925, 2000], 'pain.': [1425, 1581], 'strategies': [1427], 'ruling': [1429], 'out': [1430], 'syndrome': [1433, 1946], '(ACS)': [1434], 'consistently': [1435], 'enable': [1436], 'safe': [1437, 2508], 'discharge': [1440, 2509], 'expeditious': [1446], 'manner': [1447], 'standard': [1449, 2571], 'care': [1451, 3841], 'algorithms.12–14Also': [1452], 'setting,': [1458], 'shown': [1465, 1903], 'cost-effective,15': [1468], 'exact': [1471], 'effect': [1472], 'interpretation': [1477], 'downstream': [1479], 'resource-utilization': [1480], 'needs': [1481, 2001], 'further': [1482, 1696], 'study.13CCTA': [1483], 'considered': [1485, 2038], 'appropriate': [1486], 'nonspecific': [1491], 'pain,': [1493], 'risk,': [1498], 'normal': [1499], 'uninterpretable': [1501], 'EKG,': [1502], 'biomarkers.': [1508], 'Because': [1509], 'percentage': [1512], 'presents': [1518], 'exactly': [1520], 'manner,': [1522], 'increasing.': [1526, 1934], 'Typically,': [1527], 'majority': [1529], 'will': [1532, 1539, 1712, 1841, 1858, 2010], 'not': [1533], 'show': [1534], 'any': [1535, 1715], 'pathology': [1537], 'recommended': [1541], 'immediate': [1543], 'discharge.': [1544], 'either': [1547], 'burden': [1550, 1828], 'subsequent': [1557], '5).Download': [1566], '5.': [1569], 'Taylor': [1584, 2388], 'et': [1585], 'al': [1586], '9': [1587], '2010,': [1595], 'Wolters': [1596], 'Kluwer.': [1597], 'MI,': [1611], 'infarction.Prognostic': [1613], 'ValueThere': [1614], 'prognostic': [1620, 1716], 'setting.': [1632], 'presence': [1634], 'and,': [1638], 'amount': [1642], 'atherosclerotic': [1645, 1791, 1994], 'strongly': [1650], 'related': [1651], 'outcomes': [1654], 'chronic': [1658], 'pain.16': [1662], 'absence': [1664], 'conversely,': [1667], 'portends': [1668], 'exceedingly': [1670], 'prognosis': [1672], 'regarding': [1673], 'all-cause': [1674], 'disease-': [1676], 'morbidity': [1678], 'mortality.Data': [1680], 'stratification': [1688], 'asymptomatic': [1690, 2751, 3514], 'subjects': [1691], 'scarce,17': [1693], 'needed.': [1699], 'Accordingly,': [1700], 'currently': [1704, 1806], 'discouraged': [1705], 'outside': [1706], 'Imaging': [1710, 1731, 2264, 2652, 2761, 4063, 4343], 'rarely': [1713], 'state': [1714], 'implications': [1717], 'findings.Future': [1720], 'Directions': [1721], 'CCTAA': [1723], 'number': [1724, 2267], 'large-scale': [1726], 'trials': [1727, 1955], '(eg,': [1728], 'Prospective': [1729, 2759, 3289], 'Multicenter': [1730, 2760], 'Study': [1732, 1740, 2762, 2772], 'Evaluation': [1734, 1752, 2764, 2786], '[PROMISE],': [1738], 'International': [1739, 2771, 3163], 'Comparative': [1742, 2774], 'Health': [1743, 2775, 2973], 'Effectiveness': [1744, 2776], 'With': [1745, 2777, 2789, 3288, 3299, 4346], 'Invasive': [1748, 2780, 3930], 'Approaches': [1749, 2781, 3183, 4102], '[ISCHEMIA],': [1750], 'Randomized': [1751, 2785], 'Patients': [1754, 2624, 2788, 3298, 4345], 'Stable': [1756, 2790], 'Angina': [1757, 2791], 'Comparing': [1758, 2792], 'Utilization': [1759], 'Diagnostic': [1761, 2317, 2793, 2920, 3357, 4202, 4565], 'Examinations': [1762], '[RESCUE])18': [1763], 'ongoing': [1765, 1954], 'effectiveness': [1769], 'angina.A': [1777], 'unique': [1778], 'strength': [1779], 'ability': [1784, 1863], 'noninvasively': [1786, 1823], 'visualize,': [1787], 'quantify,': [1788], 'characterize': [1790, 1869], 'components,': [1793], 'enabling': [1794, 1975], 'vivo': [1796], 'insights': [1797], 'pathobiological': [1800], 'mechanisms': [1801], 'populations.19': [1804], 'Although': [1805], 'incompletely': [1807], 'understood,': [1808], 'identification': [1809], 'high-risk': [1811, 2424], 'features': [1813], 'precise': [1817], 'individual': [1818], 'estimates.': [1820], 'information': [1825], 'distribution': [1832], 'major': [1837], 'epicardial': [1838], 'vessels,': [1839], 'increasingly': [1842], 'establish': [1843], 'test': [1845, 2009, 3726], 'gatekeeper': [1849], 'angiography.At': [1852], 'same': [1854], 'time,': [1855], 'evolution': [1857], 'continue': [1859], 'broaden': [1861], 'comprehensively': [1868], 'Novel': [1871, 4569], 'approaches': [1872], 'include': [1873, 1956], 'single-adenosine-mediated': [1874], 'stress': [1875, 1880], 'acquisitions': [1877], 'sequential': [1879], 'obtain': [1884], 'quantitative': [1885, 4205, 4511], 'markers': [1886], 'perfusion.20': [1889], 'Also,': [1890], 'computational': [1891], 'fluid': [1892], 'dynamics': [1893], 'estimating': [1895], 'reserve': [1898, 2925, 3100, 4154, 4160, 4524], 'good': [1904], 'correlation': [1905], 'invasive': [1907, 3411, 3674, 3733, 4034, 4157, 4214, 4521], 'measurements': [1908, 4161], 'investigations.21ConclusionCCTA': [1911], 'modality': [1919], 'rapidly': [1924], 'effectiveness.': [1928], 'Adaptation': [1929], 'Current': [1935, 4444], 'its': [1938], 'low-': [1948], 'intermediate-risk': [1950], 'populations.': [1951], 'Several': [1952], 'large': [1953], 'their': [1959], 'effort': [1960], 'identify': [1962], 'strategies.': [1969], 'characteristics': [1971, 4513], 'test,': [1974], 'rapid,': [1976], 'exclusion': [1978], 'lesions': [1981], 'along': [1982], 'definition': [1985], 'distribution,': [1988], 'severity,': [1989], 'composition': [1991], 'burden,': [1995], 'uniquely': [1996], 'management.': [2004], 'utilization': [2006], 'less': [2013], 'governed': [2014], 'choice': [2017], 'versus': [2020, 2368, 2465, 2570], 'rather': [2025], 'developing': [2028], 'consensus': [2029], 'scenarios': [2033], 'appropriate.DisclosuresDr': [2039], 'consultant': [2043], 'receives': [2046], 'research': [2047], 'support': [2048], 'Bayer': [2050, 3064, 3327, 3808, 3991, 4141, 4191, 4274, 4371, 4551], 'Healthcare,': [2051, 2056], 'Bracco': [2052], 'Diagnostics,': [2053], 'General': [2054], 'Electric': [2055], 'Medrad,': [2057], 'Siemens': [2059], 'Healthcare.': [2060], 'authors': [2063], 'report': [2064], 'conflicts.FootnotesCorrespondence': [2066], 'FAHA,': [2072], 'Heart': [2073, 2126, 2168, 2429, 3124, 3224, 3301, 3560, 3884, 4067, 4609], '&': [2074], 'Vascular': [2075], 'Center,': [2076], '25': [2082], 'Courtenay': [2083], 'Drive,': [2084], 'Charleston,': [2085], 'SC': [2086], '29425-2260.': [2087], 'E-mail': [2088], '[email': [2089], 'protected]References1.': [2090], 'Menke': [2091], 'J,': [2092, 2182, 2209, 2397, 2882, 2909, 3053, 3322, 3452, 3497, 3651, 3706, 3762, 3865, 3996, 4004, 4092, 4140, 4186, 4190, 4236, 4308, 4425, 4431, 4496, 4498, 4550], 'Unterberg-Buchwald': [2093], 'C,': [2094, 2302, 2453, 2488, 2891, 3048, 3069, 3077, 3347, 3391, 3541, 3602, 3647, 3698, 3760, 3800, 3803, 3860, 3955, 3998, 4053, 4086, 4281, 4368, 4394, 4502, 4556], 'Staab': [2095], 'W,': [2096, 3493], 'Sohns': [2097], 'JM,': [2098, 2393, 2498, 2814], 'Seif': [2099], 'Amir': [2100], 'Hosseini': [2101], 'A,': [2102, 2144, 2356, 2435, 2556, 2588, 2850, 2893, 3050, 3079, 3240, 3244, 3254, 3256, 3338, 3389, 3442, 3446, 3546, 3580, 3584, 3592, 3594, 3600, 3708, 3768, 3833, 3953, 3959, 4055, 4078, 4088, 4322, 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