Should CCTA be considered the diagnostic test of choice in the outpatient evaluation of chest pain?  

CCTA can not likely stand as a way of perfectly excluding ischemic heart disease, but neither can any test, such as ETT, SET, MRA, etc.  As such, it seems attractive to individualize screening tests and even employ a complementary array of techniques. 

I think it should be individualized based on the patient’s clinical picture.

CCTA uses an anatomy-based approach to assess pathology; FFR-CT adds the ability to assess physiology. So, in theory, CCTA or CCTA-FFR should be the ideal one-stop shop. However, the evaluation of CP in the outpatient setting needs far more in comprehension, than the concise approach of CT. The exer...