title: Expectations and limitations of contemporary intravascular imaging: lessons learned from pathology.
abstract: Acute coronary syndrome is the leading cause of death worldwide and plaque rupture is the most common underlying mechanism of coronary thrombosis. During the last 2 decades the understanding of atherosclerotic plaque progression advanced dramatically and pathology studies provided fundamental insights of underlying plaque morphology, which paved the way for invasive imaging modalities, which bring a new area of atherosclerotic plaque characterization in vivo. The development of intravascular ultrasound (IVUS) allowed the field to evaluate the principles of vascular anatomy, which is often underestimated by coronary angiography. Furthermore, IVUS image technologies were developed to obtain improved characterization of plaque composition. However, since spatial resolution of IVUS is insufficient to distinguish details of plaque morphology, a broad adoption of this technology in clinical practice was missing. Optical coherence tomography is a light-based imaging modality with higher spatial resolution compared to IVUS, which enables the assessment of vascular anatomy with great detail.
authors.affiliation: CVPath, 19 Firstfield road, Gaithersburg, MD 20878, USA.
authors.forename: Oscar D
authors.initials: OD
authors.lastname: Sanchez
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sakakura
authors.forename: Fumiyuki
authors.initials: F
authors.lastname: Otsuka
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Yahagi
authors.forename: Renu
authors.initials: R
authors.lastname: Virmani
authors.forename: Michael
authors.initials: M
authors.lastname: Joner
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D017023:Coronary Angiography / Q000379:methods; D003328:Coronary Thrombosis / Q000175:diagnosis / Q000209:etiology; D003952:Diagnostic Imaging / Q000379:methods*; D018450:Disease Progression; D006801:Humans; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D041623:Tomography, Optical Coherence / Q000379:methods; D018084:Ultrasonography, Interventional / Q000379:methods