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Direct Comparison of Virtual-Histology Intravascular Ultrasound and Optical Coherence Tomography Imaging for Identification of Thin-Cap Fibroatheroma.

Brown AJ, Obaid DR, Costopoulos C, Parker RA, Calvert PA, Teng Z, Hoole SP, West NE, Goddard M, Bennett MR - Circ Cardiovasc Imaging (2015)

Bottom Line: On OCT, although minimal fibrous cap thickness was similar (71.8±44.1 μm versus 72.6±32.4; P=0.30), the number of continuous frames with fibrous cap thickness ≤85 μm was higher in TCFA (6.5 [1.75-11.0] versus 2.0 [0.0-7.0]; P=0.03).Maximum lipid arc on OCT was an excellent discriminator of fibroatheroma (area under the curve, 0.92; 95% confidence interval, 0.87-0.97) and TCFA (area under the curve, 0.86; 95% confidence interval, 0.81-0.92), with lipid arc ≥80° the optimal cut-off value.Combining VH-defined fibroatheroma and fibrous cap thickness ≤85 μm over 3 continuous frames improved TCFA identification, with diagnostic accuracy of 89.0%.

View Article: PubMed Central - PubMed

Affiliation: From the Division of Cardiovascular Medicine (A.J.B., D.R.O., C.C., P.A.C., M.R.B.), Department of Radiology (Z.T.), and Department of Engineering (Z.T.), University of Cambridge, Cambridge, United Kingdom; Health Services Research Unit, Usher Institute of Population Health Sciences and Informatics, College of Medicine and Veterinary Medicine. University of Edinburgh, Edinburgh, United Kingdom (R.A.P.); and Departments of Interventional Cardiology (S.P.H., N.E.J.W.) and Pathology (M.G.), Papworth Hospital NHS Trust, Cambridge, United Kingdom.

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Plaque classification using virtual-histology intravascular ultrasound. A–D, Examples of 4 virtual-histology intravascular ultrasound plaques (plaque burden >40%), classified as pathological intimal thickening (A), fibrocalcific plaque (B), thick-cap fibroatheroma (C), and thin-cap fibroatheroma (D).
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Figure 1: Plaque classification using virtual-histology intravascular ultrasound. A–D, Examples of 4 virtual-histology intravascular ultrasound plaques (plaque burden >40%), classified as pathological intimal thickening (A), fibrocalcific plaque (B), thick-cap fibroatheroma (C), and thin-cap fibroatheroma (D).

Mentions: VH-IVUS data were analyzed offline using echoPlaque 4.0 (Indec Medical Systems) by 2 independent observers blinded to histology and OCT. Both luminal and external elastic membrane borders were manually corrected for each frame, permitting measurement of gray-scale IVUS features, including plaque burden and luminal area. Once borders were defined, the backscattered ultrasound data were automatically processed, with colors assigned for each tissue component: fibrous (dark green), fibrofatty (light green), NC (red), and dense calcium (white). VH-defined plaque classification (Figure 1) was performed using an established classification system; full details are found in the Methods section of Data Supplement.6 A consensus was obtained in cases of disagreement and this value used in subsequent analysis. Interobserver agreement for VH-defined plaque classification was strong (κ=0.84; 95% confidence interval [CI], 0.78–0.90; Table I in the Data Supplement).


Direct Comparison of Virtual-Histology Intravascular Ultrasound and Optical Coherence Tomography Imaging for Identification of Thin-Cap Fibroatheroma.

Brown AJ, Obaid DR, Costopoulos C, Parker RA, Calvert PA, Teng Z, Hoole SP, West NE, Goddard M, Bennett MR - Circ Cardiovasc Imaging (2015)

Plaque classification using virtual-histology intravascular ultrasound. A–D, Examples of 4 virtual-histology intravascular ultrasound plaques (plaque burden >40%), classified as pathological intimal thickening (A), fibrocalcific plaque (B), thick-cap fibroatheroma (C), and thin-cap fibroatheroma (D).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4596008&req=5

Figure 1: Plaque classification using virtual-histology intravascular ultrasound. A–D, Examples of 4 virtual-histology intravascular ultrasound plaques (plaque burden >40%), classified as pathological intimal thickening (A), fibrocalcific plaque (B), thick-cap fibroatheroma (C), and thin-cap fibroatheroma (D).
Mentions: VH-IVUS data were analyzed offline using echoPlaque 4.0 (Indec Medical Systems) by 2 independent observers blinded to histology and OCT. Both luminal and external elastic membrane borders were manually corrected for each frame, permitting measurement of gray-scale IVUS features, including plaque burden and luminal area. Once borders were defined, the backscattered ultrasound data were automatically processed, with colors assigned for each tissue component: fibrous (dark green), fibrofatty (light green), NC (red), and dense calcium (white). VH-defined plaque classification (Figure 1) was performed using an established classification system; full details are found in the Methods section of Data Supplement.6 A consensus was obtained in cases of disagreement and this value used in subsequent analysis. Interobserver agreement for VH-defined plaque classification was strong (κ=0.84; 95% confidence interval [CI], 0.78–0.90; Table I in the Data Supplement).

Bottom Line: On OCT, although minimal fibrous cap thickness was similar (71.8±44.1 μm versus 72.6±32.4; P=0.30), the number of continuous frames with fibrous cap thickness ≤85 μm was higher in TCFA (6.5 [1.75-11.0] versus 2.0 [0.0-7.0]; P=0.03).Maximum lipid arc on OCT was an excellent discriminator of fibroatheroma (area under the curve, 0.92; 95% confidence interval, 0.87-0.97) and TCFA (area under the curve, 0.86; 95% confidence interval, 0.81-0.92), with lipid arc ≥80° the optimal cut-off value.Combining VH-defined fibroatheroma and fibrous cap thickness ≤85 μm over 3 continuous frames improved TCFA identification, with diagnostic accuracy of 89.0%.

View Article: PubMed Central - PubMed

Affiliation: From the Division of Cardiovascular Medicine (A.J.B., D.R.O., C.C., P.A.C., M.R.B.), Department of Radiology (Z.T.), and Department of Engineering (Z.T.), University of Cambridge, Cambridge, United Kingdom; Health Services Research Unit, Usher Institute of Population Health Sciences and Informatics, College of Medicine and Veterinary Medicine. University of Edinburgh, Edinburgh, United Kingdom (R.A.P.); and Departments of Interventional Cardiology (S.P.H., N.E.J.W.) and Pathology (M.G.), Papworth Hospital NHS Trust, Cambridge, United Kingdom.

Show MeSH
Related in: MedlinePlus