This review examines methodologies employed in deriving physiology from cardiac computed tomography angiography (CCTA), focusing on two primary approaches:1) fractional flow reserve (FFR) calculated from CT images using computational fluid dynamics (CT-FFR); and 2) plaque-derived ischemia/FFR assessment utilizing artificial intelligence and quantitative metrics. Each methodology offers unique advantages in diagnosing and managing coronary artery disease, contributing to CCTA’s evolution into a d…