title: Intravascular optical coherence tomography: comparison with histopathology in atherosclerotic peripheral artery specimens.
abstract: OBJECTIVE
  Intravascular optical coherence tomography (OCT) is a new imaging modality that provides microstructural information on atherosclerotic plaques and has an axial resolution of 10-20 microm. OCT of coronary arteries characterizes different atherosclerotic plaque components by their distinctive signal patterns. Peripheral human arteries were examined ex vivo by means of OCT, and attempts to distinguish among fibrous, lipid-rich, and calcified atherosclerotic plaques were made based on imaging criteria previously established for coronary arteries.
  
  
  METHODS
  One hundred fifty-one atherosclerotic arterial segments were obtained from 15 below-knee amputations. OCT imaging criteria for different plaque types (fibrous, lipid-rich, calcified) were established in a subset of 30 arterial segments. The remaining 121 OCT images were analyzed by two independent readers. Each segment was divided into four quadrants. Agreement between histopathology and OCT was quantified by the kappa test of concordance, as were interobserver, intraobserver, and inter-method variability.
  
  
  RESULTS
  Four hundred sixty-nine of 484 quadrants (97%) were available for comparison. Sensitivity and specificity for OCT criteria (consensus readers 1 and 2) were 86% and 86% for fibrous plaques, 78% and 93% for lipid-rich plaques, and 84% and 95% for calcified plaques, respectively (overall agreement, 84%). The interobserver and intraobserver reliabilities of OCT assessment were high (kappa values of 0.84 and 0.87, respectively). The inter-method agreement was 0.74 for consensus OCT versus consensus histology.
  
  
  CONCLUSIONS
  OCT of peripheral human arteries ex vivo characterized different atherosclerotic plaque types with a high degree of agreement with histopathologic findings. Findings were comparable to those reported for coronary arteries. OCT promises to improve understanding of the progression or regression of peripheral atherosclerosis in vivo.
authors.affiliation: Institute for Clinical Radiology, Institute of Pathology, Ludwig-Maximilians-University, Munich. oliver.meissner@med.uni-muenchen.de
authors.forename: Oliver A
authors.initials: OA
authors.lastname: Meissner
authors.forename: Johannes
authors.initials: J
authors.lastname: Rieber
authors.forename: Gregor
authors.initials: G
authors.lastname: Babaryka
authors.forename: Melanie
authors.initials: M
authors.lastname: Oswald
authors.forename: Susanne
authors.initials: S
authors.lastname: Reim
authors.forename: Uwe
authors.initials: U
authors.lastname: Siebert
authors.forename: Thomas
authors.initials: T
authors.lastname: Redel
authors.forename: Maximilian
authors.initials: M
authors.lastname: Reiser
authors.forename: Ullrich
authors.initials: U
authors.lastname: Mueller-Lisse
mesh_terms: D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000473:pathology*; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D016491:Peripheral Vascular Diseases / Q000473:pathology*; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence