The present invention relates to assessing coronary microvascular dysfunction. In order to provide a more effective assessment of potential coronary microvascular dysfunction, the decision-support system comprises an input unit, a cardiac anatomy segmentation unit, a perfusion data extraction unit, a coronary microvascular dysfunction prediction unit, and an output unit. The input unit is configured to receive coronary computed tomography angiography data of a patient and a corresponding scan protocol. The cardiac anatomy segmentation unit is configured to segment the received coronary computed tomography angiography data to generate a cardiac segmentation map depicting multiple anatomical segments including myocardium segments. The perfusion data extraction unit is configured to extract perfusion data from the received coronary computed tomography angiography data. The coronary microvascular dysfunction prediction unit is configured to use a statistical model to determine an indicator for a presence of coronary microvascular dysfunction based on the received coronary computed tomography angiography data, the corresponding scan protocol, and patient-related data including the generated cardiac segmentation map and the extracted perfusion data. The output unit is configured to output the indicator for a presence of coronary microvascular dysfunction.
