Optical coherence tomography attenuation imaging for lipid core detection: an ex-vivo validation study.
Lipid-core atherosclerotic plaques are associated with disease progression, procedural complications, and cardiac events. Coronary plaque lipid can be quantified in optical coherence tomography (OCT) pullbacks by measurement of lipid arcs and lipid lengths; parameters frequently used in clinical research, but labor intensive and subjective to analyse. In this study, we investigated the ability of quantitative attenuation, derived from intravascular OCT, to detect plaque lipid. Lipid cores are associated with a high attenuation coefficient. We compared the index of plaque attenuation (IPA), a local quantitative measure of attenuation, to the manually measured lipid score (arc and length) on OCT images, and to the plaque characterization ex-vivo. We confirmed a correlation between the IPA and lipid scores (r2> 0.7). Comparison to histology shows that high attenuation is associated with fibroatheroma, but also with macrophage presence. IPA is a robust, reproducible, and user-independent measure that facilitates quantification of coronary lipid, a potential tool in clinical research and in guiding percutaneous coronary intervention.
Department of Biomedical Engineering, Erasmus Medical Center, PO Box 2040, 3000, Rotterdam, CA, The Netherlands.
Muthukaruppan
M
Gnanadesigan
Bristol Heart Institute, Bristol, UK.
Ali S
AS
Hussain
School of Clinical Sciences, University of Bristol, Bristol, UK.
Stephen
S
White
School of Clinical Sciences, University of Bristol, Bristol, UK.
Simon
S
Scoltock
Bristol Heart Institute, Bristol, UK.
Andreas
A
Baumbach
Department of Biomedical Engineering, Erasmus Medical Center, PO Box 2040, 3000, Rotterdam, CA, The Netherlands.|Department of Imaging Science and Technology, Delft University of Technology, Lorentzweg 1, 2628, Delft, CJ, The Netherlands.
Antonius F W
AF
van der Steen
Thorax Center, Erasmus Medical Center, PO Box 2040, 3000, Rotterdam, CA, The Netherlands.
Evelyn
E
Regar
Bristol Heart Institute, Bristol, UK.
Thomas W
TW
Johnson
Department of Biomedical Engineering, Erasmus Medical Center, PO Box 2040, 3000, Rotterdam, CA, The Netherlands. g.vansoest@erasmusmc.nl.
Gijs
G
van Soest
D002102:Cadaver; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D003331:Coronary Vessels / Q000737:chemistry / Q000000981:diagnostic imaging* / Q000473:pathology; D005355:Fibrosis; D006801:Humans; D008055:Lipids / Q000032:analysis*; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D041623:Tomography, Optical Coherence
D008055:Lipids
Attenuation; Lipid core plaque; Optical coherence tomography