title: Prospective evaluation of optical coherence tomography in lower limb arteries compared with intravascular ultrasound.
abstract: OBJECTIVE
  To compare in a prospective noninferiority study optical coherence tomography (OCT) and intravascular ultrasound (IVUS) in popliteal and infrapopliteal vessels.
  
  
  METHODS
  OCT and IVUS images of 112 popliteal and infrapopliteal arterial segments were prospectively obtained from 16 patients with peripheral arterial occlusive disease. Three observers evaluated the corresponding OCT and IVUS images for image quality, artifact frequency, discriminability of vessel wall layers, and plaque composition. Measurements of the lumen, vessel, and plaque areas were compared for both modalities.
  
  
  RESULTS
  The intrareader and interreader reproducibility of plaque tissue discrimination (0.88 vs 0.75), overall image quality, and vessel wall layer discriminability were significantly higher for OCT (all P < .001). Artifact frequency was higher in OCT, constraining the imaging of the tibioperoneal trunk. The results of measurements of the lumen and vessel area were comparable for both modalities (correlation > 0.9, P < .001). Plaque area measurements differed (correlation 0.8, P < .01) because OCT underestimated it. The OCT procedure caused vessel spasms in two patients.
  
  
  CONCLUSIONS
  OCT imaging of infrapopliteal arteries is feasible and safe and provides high image quality. It enables an accurate assessment of vessel lumen, wall, and plaque. Compared with IVUS, OCT images provide excellent image quality and superior visualization of vessel wall layers and different plaque components. The penetration depth of OCT restricts its use to suitable vessel regions.
authors: Institute for Clinical Radiology, Hospitals of the Ludwig-Maximilians-University of Munich, Ziemssenstrasse 1, 80336 Munich, Germany. Electronic address: karla_maria.eberhardt@med.uni-muenchen.de.
authors: Karla Maria
authors: KM
authors: Eberhardt
authors: Marcus
authors: M
authors: Treitl
authors: Katrin
authors: K
authors: Boesenecker
authors: Daniel
authors: D
authors: Maxien
authors: Maximilian
authors: M
authors: Reiser
authors: Johannes
authors: J
authors: Rieger
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007866:Leg / Q000033:anatomy & histology / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D058729:Peripheral Arterial Disease / Q000175:diagnosis*; D011150:Popliteal Artery / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence / Q000379:methods*; D018084:Ultrasonography, Interventional / Q000379:methods*
keywords: DSA; ICC; OCT; digital subtraction angiography; intraclass correlation; optical coherence tomography