Fluorescence Lifetime Imaging Combined with Conventional Intravascular Ultrasound for Enhanced Assessment of Atherosclerotic Plaques: an Ex Vivo Study in Human Coronary Arteries.
This study evaluates the ability of label-free fluorescence lifetime imaging (FLIm) to complement intravascular ultrasound (IVUS) for concurrent visualization of human coronary vessel composition, structure, and pathology. Co-registered FLIm and IVUS data from 16 coronary segments were correlated to eight distinct pathological features including thin-cap fibroatheroma (TCFA). The sensitivity, specificity, and positive predictive value for combined FLIm-IVUS (89, 99, 89 %) were better than FLIm (70, 98, 88 %) and IVUS (45, 94, 62 %) alone in distinguishing between pathologies. FLIm can assess compositional changes in luminal surface through variations in fluorescence lifetime values (<3.5 ns for lipid-rich areas; >4 ns for collagen-rich areas) enabling detection of macrophages in fibrous caps (sensitivity, 86 %) and distinguishing between relatively stable thick-cap fibroatheromas and rupture-prone TCFA (sensitivity, 80 %) amongst other features. Current results demonstrate the potential of FLIm-IVUS as a new intravascular method for improved evaluation of plaques that may subsequently aid in guiding coronary intervention.
Department of Biomedical Engineering, University of California Davis, 451 E. Health Sciences Drive, Davis, CA, 95616, USA.
Hussain
H
Fatakdawala
Dimitris
D
Gorpas
John W
JW
Bishop
Julien
J
Bec
Dinglong
D
Ma
Jeffrey A
JA
Southard
Kenneth B
KB
Margulies
Laura
L
Marcu
D003094:Collagen / Q000032:analysis; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D005240:Feasibility Studies; D005355:Fibrosis; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008055:Lipids / Q000032:analysis; D008264:Macrophages / Q000737:chemistry / Q000000981:diagnostic imaging / Q000473:pathology; D064847:Multimodal Imaging / Q000379:methods*; D061848:Optical Imaging; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012422:Rupture, Spontaneous; D018084:Ultrasonography, Interventional
D008055:Lipids; D003094:Collagen