Short version: PIA offers CT-derived fractional flow reserve. You send us a coronary CTA, we return FFR values and 3D models to your PACS, and you never buy a workstation, license software, or hire anyone to run it.

If that answers your question, talk to us. The rest of this explains how it works and what it costs.

What you get

CT FFR turns a coronary CTA you have already acquired into a functional answer. Instead of sending a patient with an intermediate lesion to the cath lab to find out whether the stenosis is actually limiting flow, you find out from the scan.

Through PIA, that analysis runs on DeepVessel FFR, made by Keya Medical. It builds a three-dimensional model of the coronary tree from your CCTA and estimates FFR values along it. What comes back to your PACS is a full report: the 3D model, interactive, with FFR values mapped along the vessels, ready for your physician to interpret and sign.

DeepVessel maps those values semi-continuously along the whole reconstructed tree rather than reporting one number at one location. With serial lesions or diffuse disease, a pressure profile down the vessel tells you which segment is driving the ischemia. A single point measurement does not.

Analysis runs in minutes.

How you send us a study

There are three steps and you are responsible for one of them.

1. You upload the CCTA securely to the PIA Cloud.
2. We route it to DeepVessel FFR for analysis.
3. The report returns to your PACS, where your physicians already work.

No workstation goes into the reading room. No software gets installed on your network. No one on your staff needs to learn a new tool, get certified on it, or be available to run it at 9pm on a Saturday.

You can send us your full CCTA volume, or only the studies where you want a functional answer. Both work.

Why through a service instead of buying it

Any hospital can license CT FFR software. The license is the cheap part.

What follows the license is a workstation, a validation process, someone trained to operate the tool, coverage for that person's vacations, and a plan for the six months after they leave. For a program running a moderate CCTA volume, the staffing overhead frequently costs more than the analyses are worth, which is why plenty of departments evaluate CT FFR, agree it is clinically valuable, and never start.

Routing studies to us removes all of that. There is no capital cost, no headcount, and no coverage gap. One of our clients at Hawaii Pacific Health put it directly: the arrangement let them give referring clinicians quantitative functional analyses without the cost and personnel training an onsite analysis package would have required.

It also means CT FFR arrives through the same pathway that already handles your CCTA reconstructions, calcium scoring, and structural heart planning. One relationship, not a separate vendor for one study type.

The evidence

DeepVessel FFR is FDA-cleared. It also carries CE marking and NMPA approval.

Clearance rests on a multicenter validation study led by Joseph Schoepf, MD, at the Medical University of South Carolina, covering 269 patients and 358 target vessels across ten clinical sites in the US and EU. Invasive FFR was the reference standard. The study met its pre-specified endpoints for per-vessel sensitivity and specificity.

The comparator there was the pressure wire, which is the right bar for a test whose purpose is to reduce how often you need one. DeepVessel cleared the FDA in April 2022 and has been available for US clinical use since January 2023.

Reimbursement

CT FFR is reimbursed, and this changed recently enough that it is worth restating if your last look was a few years ago.

Effective January 1, 2024, the AMA established a Category I CPT code for FFR-CT: 75580, replacing the four Category III codes that came before it. The shift from Category III to Category I signals an established service with assigned RVUs rather than an emerging one. CMS assigned the code to APC 5724 in the CY 2024 OPPS rule and increased hospital outpatient payment by roughly 7%. Major commercial payers maintain FFR-CT policies, generally covering intermediate-risk patients with 40% to 90% stenosis in a proximal or mid vessel.

Two practical notes. The code covers the software analysis, physician interpretation, and report, but not the CT acquisition. And billing is more involved when acquisition, analysis, and interpretation sit in different organizations, which is true of any outsourced model. Worth walking through with your revenue cycle team before the first case.

What your CCTAs need to look like

One thing we would rather tell you upfront than after a rejected study.

CT FFR is less tolerant of image quality problems than a human read is. The computation depends on segmenting the lumen boundary precisely and estimating myocardial mass, and where a radiologist can compensate for moderate motion blur by looking at the vessel another way, the algorithm cannot. Published rejection rates for FFR-CT run 10% to 25%, and motion accounts for around 80% of the disqualifications.

In practice that means heart rate control matters more than anything else, full myocardial coverage in the field of view is non-negotiable, and heavy calcification is the hard case because blooming distorts the lumen the software is trying to measure.

If you are already running CCTA well, you are most of the way there. If your rejection rate is running high, it is nearly always fixable in acquisition, and we are happy to look at your protocol with you.

Common questions

Do we need to buy a workstation or software license? No. Studies route through the PIA Cloud, results come back to your PACS.

How fast is it? Keya reports analysis in minutes. Total turnaround depends on your submission workflow; we work to guaranteed turnaround times.

How accurate is it? FFR-CT has demonstrated diagnostic accuracy comparable to invasive FFR across the literature. DeepVessel's validation used invasive FFR as the gold standard and met its endpoints.

Is it reimbursed? Yes, under CPT 75580 since January 2024. Verify current payer policy for your dates of service.

Can we send only part of our volume? Yes. Full volume or overflow only.

What else can you process? Cardiac, vascular, and neuro post-processing across CT and MR, including CCTA, calcium scoring, TAVR and TMVR planning, CTA runoff, and neuro perfusion.

Adding CT FFR to your program

If your department is running CCTA volume and sending intermediate lesions to the cath lab to answer a question the scan could answer, CT FFR is worth a conversation. We can have you submitting studies without a purchase order, a workstation, or a new hire.

Speak with an expert