title: OCT-measured plaque free wall angle is indicative for plaque burden: overcoming the main limitation of OCT?
abstract: The aim of this study was to investigate the relationship between the plaque free wall (PFW) measured by optical coherence tomography (OCT) and the plaque burden (PB) measured by intravascular ultrasound (IVUS). We hypothesize that measurement of the PFW could help to estimate the PB, thereby overcoming the limited ability of OCT to visualize the external elastic membrane in the presence of plaque. This could enable selection of the optimal stent-landing zone by OCT, which is traditionally defined by IVUS as a region with a PB < 40 %. PB (IVUS) and PFW angle (OCT and IVUS) were measured in 18 matched IVUS and OCT pullbacks acquired in the same coronary artery. We determined the relationship between OCT measured PFW (PFWOCT) and IVUS PB (PBIVUS) by non-linear regression analysis. An ROC-curve analysis was used to determine the optimal cut-off value of PFW angle for the detection of PB < 40 %. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. There is a significant correlation between PFWOCT and PBIVUS (r(2) = 0.59). The optimal cut-off value of the PFWOCT for the prediction of a PBIVUS < 40 % is ≥220° with a PPV of 78 % and an NPV of 84 %. This study shows that PFWOCT can be considered as a surrogate marker for PBIVUS, which is currently a common criterion to select an optimal stent-landing zone.
authors.affiliation: Biomechanics Laboratory, Department of Cardiology, Biomedical Engineering, EE2334b, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands. a.hoogendoorn@erasmusmc.nl.
authors.forename: Ayla
authors.identifier: http://orcid.org/0000-0002-3381-8779
authors.initials: A
authors.lastname: Hoogendoorn
authors.affiliation: Biomechanics Laboratory, Department of Cardiology, Biomedical Engineering, EE2334b, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Muthukaruppan
authors.initials: M
authors.lastname: Gnanadesigan
authors.affiliation: Biomedical Imaging Group Rotterdam, Departments of Radiology & Nuclear Medicine and Medical Informatics, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Zahnd
authors.affiliation: Interventional Cardiology, Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Nienke S
authors.initials: NS
authors.lastname: van Ditzhuijzen
authors.affiliation: Biomechanics Laboratory, Department of Cardiology, Biomedical Engineering, EE2334b, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Johan C H
authors.initials: JC
authors.lastname: Schuurbiers
authors.affiliation: Biomechanics Laboratory, Department of Cardiology, Biomedical Engineering, EE2334b, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Gijs
authors.initials: G
authors.lastname: van Soest
authors.affiliation: Interventional Cardiology, Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Regar
authors.affiliation: Biomechanics Laboratory, Department of Cardiology, Biomedical Engineering, EE2334b, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Jolanda J
authors.initials: JJ
authors.lastname: Wentzel
mesh_terms: D019540:Area Under Curve; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D006801:Humans; D017711:Nonlinear Dynamics; D015588:Observer Variation; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015607:Stents; D041623:Tomography, Optical Coherence; D018084:Ultrasonography, Interventional
keywords: Intravascular ultrasound; Optical coherence tomography; Plaque burden; Plaque free wall; Stent-landing zone