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Coronary angiography or cineangiography provides direct visualization of the coronary luminal anatomy and is the gold standard for the diagnosis of coronary artery disease. 1 However, since the development of angiography in the 1960s, the primary method for assessing the lesions that are of physiologic significance has been visual assessment by the operator, 2 which is prone to significant intraobserver and interobserver variability. 2–4 The significance of a given stenosis is not determined solely by the reduction in luminal diameter, because numerous additional factors such as lesion length, shape, and eccentricity affect the flow dynamics of the lesion and thus the physiologic significance. 5–9 Therefore, coronary angiography cannot solely be relied on to provide the physiologic or clinical significance of a stenosis, particularly when the vessel is narrowed to between 40% and 80% of its normal diameter. 10, 11 …