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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: Combining VH-defined fibroatheroma and fibrous cap thickness ≤85 μm over 3 continuous frames improved TCFA identification, with diagnostic accuracy of 89.0%.Both VH-IVUS and OCT can reliably identify TCFA, although OCT accuracy may be improved using lipid arc ≥80° and fibrous cap thickness ≤85 μm over 3 continuous frames.Combined VH-IVUS/OCT imaging markedly improved TCFA identification.

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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Coregistration between histology and intravascular imaging. Example of a plaque classified as pathological intimal thickening on histology (A), with coregistered virtual-histology intravascular ultrasound (VH-IVUS; B) and optical coherence tomography (OCT; C) images. Corresponding longitudinal VH-IVUS (D) and OCT (E) pullbacks denoting the location of the plaque within these vessels (yellow bar), with a small side-branch (arrow) and large bifurcation (*) used to assist colocalization.
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Figure 3: Coregistration between histology and intravascular imaging. Example of a plaque classified as pathological intimal thickening on histology (A), with coregistered virtual-histology intravascular ultrasound (VH-IVUS; B) and optical coherence tomography (OCT; C) images. Corresponding longitudinal VH-IVUS (D) and OCT (E) pullbacks denoting the location of the plaque within these vessels (yellow bar), with a small side-branch (arrow) and large bifurcation (*) used to assist colocalization.

Mentions: Overall, 1290 mm of coronary artery were analyzed representing 258 histological ROI, with VH-IVUS available for 211 (81.8%), OCT for 207 (80.2%), and dual imaging for 200 (77.5%). VH-IVUS and OCT image sets were matched to coregistered histological ROI by an experienced intravascular imaging investigator, blinded to final histological plaque classification. Coregistration was aided by detailed measurements taken during ex vivo imaging using fiduciary landmarks, including bifurcations, guide catheter location, and prominent calcific deposits (Figure 3). By histology, ROI were classified as adaptive intimal thickening 97 (37.6%), pathological intimal thickening 50 (19.4%), fibrocalcific 38 (14.7%), and fibroatheroma 73 (28.3%). Of the ROI classified as fibroatheroma, 22 met the criteria for TCFA (8.5% of total ROI) with mean FCT on histology being 43.0±16.8 μm. All TCFA were imaged by both VH-IVUS and OCT. ROI that could not be imaged were all located in distal coronary segments and were classified as adaptive intimal thickening (66.7%), pathological intimal thickening (17.5%), fibrocalcific (8.7%), and fibroatheroma (7.0%).


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)

Coregistration between histology and intravascular imaging. Example of a plaque classified as pathological intimal thickening on histology (A), with coregistered virtual-histology intravascular ultrasound (VH-IVUS; B) and optical coherence tomography (OCT; C) images. Corresponding longitudinal VH-IVUS (D) and OCT (E) pullbacks denoting the location of the plaque within these vessels (yellow bar), with a small side-branch (arrow) and large bifurcation (*) used to assist colocalization.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Coregistration between histology and intravascular imaging. Example of a plaque classified as pathological intimal thickening on histology (A), with coregistered virtual-histology intravascular ultrasound (VH-IVUS; B) and optical coherence tomography (OCT; C) images. Corresponding longitudinal VH-IVUS (D) and OCT (E) pullbacks denoting the location of the plaque within these vessels (yellow bar), with a small side-branch (arrow) and large bifurcation (*) used to assist colocalization.
Mentions: Overall, 1290 mm of coronary artery were analyzed representing 258 histological ROI, with VH-IVUS available for 211 (81.8%), OCT for 207 (80.2%), and dual imaging for 200 (77.5%). VH-IVUS and OCT image sets were matched to coregistered histological ROI by an experienced intravascular imaging investigator, blinded to final histological plaque classification. Coregistration was aided by detailed measurements taken during ex vivo imaging using fiduciary landmarks, including bifurcations, guide catheter location, and prominent calcific deposits (Figure 3). By histology, ROI were classified as adaptive intimal thickening 97 (37.6%), pathological intimal thickening 50 (19.4%), fibrocalcific 38 (14.7%), and fibroatheroma 73 (28.3%). Of the ROI classified as fibroatheroma, 22 met the criteria for TCFA (8.5% of total ROI) with mean FCT on histology being 43.0±16.8 μm. All TCFA were imaged by both VH-IVUS and OCT. ROI that could not be imaged were all located in distal coronary segments and were classified as adaptive intimal thickening (66.7%), pathological intimal thickening (17.5%), fibrocalcific (8.7%), and fibroatheroma (7.0%).

Bottom Line: Combining VH-defined fibroatheroma and fibrous cap thickness ≤85 μm over 3 continuous frames improved TCFA identification, with diagnostic accuracy of 89.0%.Both VH-IVUS and OCT can reliably identify TCFA, although OCT accuracy may be improved using lipid arc ≥80° and fibrous cap thickness ≤85 μm over 3 continuous frames.Combined VH-IVUS/OCT imaging markedly improved TCFA identification.

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