Here is the design of a clinical trial:

Official Title: Diagnostic Accuracy of Spectral Computed Tomography for Detection of Flow Limiting Coronary Stenosis Using Fractional Flow Reserve as the Standard of Reference

Included conditions:
- Coronary Stenosis
- Myocardial Ischemia
- Cardiovascular Diseases

Study Armgroups:

Interventions:
- {'type': 'DEVICE', 'name': 'Dual-layer spectral detector CT', 'description': 'A dual energy CT approach', 'otherNames': ['SDCT']}

Primary Outcomes:
- {'measure': 'Flow limiting stenosis in the coronary arteries defined by invasive fractional flow reserve (FFR)', 'description': 'An invasive FFR \\<0.8 indicates a flow limiting stenosis', 'timeFrame': 'within 30 days'}

Please estimate the sample size based on the assumption: 
The significance level is not explicitly stated, but the confidence intervals (CIs) are mentioned: the lower limit of the 95% CI for specificity should increase from 35% to 60%, and the lower limit of the 95% CI for sensitivity should be around 65%. An attrition rate is considered, leading to an increase in the sample size.
Sample size calculation
        To allow for evaluation of sensitivity and specificity within our study population, the proportions of cases (FFRÂ â¤0.80) and controls (FFRÂ >0.8) in our sample should take the prevalence of disease into account. Internal research of patient records of the past 3 years showed that 50% of the patients who underwent invasive FFR had at least one positive FFR measurement (FFRÂ â¤0.80). With a prevalence of 0.5, the proportion of cases to controls is 1, indicating that the same amount of cases and controls is required. The main goal of the CLARITY study is to increase the specificity of SDCT (including CTP) for the identification of functionally significant coronary artery stenosis. In the targeted population, the sensitivity and specificity of CCTA are currently around 95% and 50%, respectively.1â3 Using SDCT (including CTP), we aim to increase the specificity from 50% to 85%.22â24 Raising the lower limit of the 95% CI for specificity from a typical value of 35% to 60%, necessitates inclusion of at least 66 patients (33 cases and 33 controls).25 However, this should not come at a too high cost in sensitivity. Using SDCT (including CTP), we expect a sensitivity around 90% with a lower limit of the 95% CI of 65%,22â24 which necessitates inclusion of at least 62 patients (31 cases and 31 controls).25 Because we are interested in both the sensitivity and specificity, we take the largest number of patients of the two calculated sample sizes (n=66). To account for attrition, 75 patients will be included. Our internal research also showed that in most cases FFR is measured in more than one vessel, with an average of 1.6 vessels per patient. Thus, for evaluation on a vessel basis, the amount of measurements is expected to be around 120 individual measurements.