title: Virtual histology intravascular ultrasound compared with optical coherence tomography for identification of thin-cap fibroatheroma.
abstract: Virtual histology intravascular ultrasound (VH-IVUS) allows detailed assessment of plaque composition in the clinical setting. Optical coherence tomography (OCT) has been developed as a high-resolution imaging method, which might be a promising technique to identify thin-cap fibroatheroma (TCFA) in vivo. The purpose of the present study was to evaluate the diagnostic accuracy of VH-IVUS to identify TCFA as determined by OCT.We examined 96 target lesions in patients with stable angina pectoris by using VH-IVUS and OCT. VH-IVUS derived TCFA was defined as a focal necrotic core-rich lesion without evident overlying fibrous tissue. OCT derived TCFA was defined as a plaque with a fibrous cap of < 65 µm. VH-IVUS correctly identified 16 TCFA and 67 non-TCFA but misclassified 2 TCFA and 11 non-TCFA as determined by OCT. The sensitivity, specificity, and positive and negative predictive values of VH-IVUS to identify TCFA as determined by OCT were 89%, 86%, 59%, and 97%, respectively.VH-IVUS showed an acceptable sensitivity and specificity to identify TCFA as determined by OCT. Although the positive predictive value was low reflecting a high number of false positives, the negative predictive value was notably high. Our results suggest a potential role for VH-IVUS to exclude high risk lesions for future coronary events.
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kubo
authors.forename: Nobuo
authors.initials: N
authors.lastname: Nakamura
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Matsuo
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Okumoto
authors.forename: Xiaofan
authors.initials: X
authors.lastname: Wu
authors.forename: So-Yeon
authors.initials: SY
authors.lastname: Choi
authors.forename: Kenichi
authors.initials: K
authors.lastname: Komukai
authors.forename: Takashi
authors.initials: T
authors.lastname: Tanimoto
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ino
authors.forename: Hironori
authors.initials: H
authors.lastname: Kitabata
authors.forename: Keizo
authors.initials: K
authors.lastname: Kimura
authors.forename: Masato
authors.initials: M
authors.lastname: Mizukoshi
authors.forename: Toshio
authors.initials: T
authors.lastname: Imanishi
authors.forename: Hideharu
authors.initials: H
authors.lastname: Akagi
authors.forename: Tadao
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Akasaka
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D058226:Plaque, Atherosclerotic / Q000175:diagnosis* / Q000000981:diagnostic imaging; D041623:Tomography, Optical Coherence; D018084:Ultrasonography, Interventional