Diagnostic accuracy of optical coherence tomography and integrated backscatter intravascular ultrasound images for tissue characterization of human coronary plaques.
OBJECTIVE
The purpose of the present study was to validate the diagnostic accuracy of optical coherence tomography (OCT), integrated backscatter intravascular ultrasound (IB-IVUS), and conventional intravascular ultrasound (C-IVUS) for tissue characterization of coronary plaques and to evaluate the advantages and limitations of each of these modalities.


BACKGROUND
The diagnostic accuracy of OCT for characterizing tissue types is well established. However, comparisons among OCT, C-IVUS, and IB-IVUS have not been done.


METHODS
We examined 128 coronary arterial sites (42 coronary arteries) from 17 cadavers; IVUS and OCT images were acquired on the same slice as histology. Ultrasound signals were obtained using an IVUS system with a 40-MHz catheter and digitized at 1 GHz with 8-bit resolution. The IB values of the ultrasound signals were calculated with a fast Fourier transform.


RESULTS
Using histological images as a gold standard, the sensitivity of OCT for characterizing calcification, fibrosis, and lipid pool was 100%, 98%, and 95%, respectively. The specificity of OCT was 100%, 94%, and 98%, respectively (Cohen's kappa = 0.92). The sensitivity of IB-IVUS was 100%, 94%, and 84%, respectively. The specificity of IB-IVUS was 99%, 84%, and 97%, respectively (Cohen's kappa = 0.80). The sensitivity of C-IVUS was 100%, 93%, and 67%, respectively. The specificity of C-IVUS was 99%, 61%, and 95%, respectively (Cohen's kappa = 0.59).


CONCLUSIONS
Within the penetration depth of OCT, OCT has a best potential for tissue characterization of coronary plaques. Integrated backscatter IVUS has a better potential for characterizing fibrous lesions and lipid pools than C-IVUS.
Kawasaki
Masanori
M
Wellman Laboratories of Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA. masanori@ya2.so-net.ne.jp
Bouma
Brett E
BE
Bressner
Jason
J
Houser
Stuart L
SL
Nadkarni
Seemantini K
SK
MacNeill
Briain D
BD
Jang
Ik-Kyung
IK
Fujiwara
Hisayoshi
H
Tearney
Guillermo J
GJ
D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology; D005355:Fibrosis / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D066298:In Vitro Techniques; D015588:Observer Variation; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology; D018084:Ultrasonography, Interventional