Intravascular multimodality imaging: feasibility and role in the evaluation of coronary plaque pathology.
Coronary artery disease remains the leading cause of death in the developed world. Over recent years, research has been focused on the development of diagnostic intravascular imaging techniques that enable assessment of plaque composition and morphology, and allow identification of vulnerable, high-risk lesions. Nevertheless recent studies of coronary atherosclerosis have shown that invasive modalities have a limited accuracy in detecting lesions that will progress and cause events, whilst histology-based studies also highlighted the limitations of invasive imaging in assessing plaque characteristics. To overcome these drawbacks, multimodality imaging has been proposed. Although it is apparent that coronary imaging with two or three imaging modalities is time consuming and is associated with a risk of complications, evidence from small clinical studies demonstrated that it provides incremental information about plaque pathology and biology and underscored the need to develop dual-probe hybrid imaging catheters that would enable complete and comprehensive assessment of plaque morphology. This paper reviews the current clinical evidence that supports the use of multimodality intravascular imaging in the study of atherosclerosis, summarizes the key findings of the first invasive imaging studies that utilize hybrid dual-probe catheters, and discusses the limitations of combined intravascular imaging that restrict its broad application in both the clinical and research arena.
Barts Heart Centre, Barts Health NHS Trust, London, UK.
Michael
M
Michail
Faculty of Medicine, National Heart & Lung Institute, Imperial College London, UK.|Department of Interventional Cardiology, Erasmus University Medical Centre, Thoraxcenter, Rotterdam, The Netherlands.
Patrick W
PW
Serruys
Barts Heart Centre, Barts Health NHS Trust, London, UK.
Rodrigue
R
Stettler
Barts Heart Centre, Barts Health NHS Trust, London, UK.
Tom
T
Crake
Department of Mechanical Engineering, University College London, UK.
Ryo
R
Torii
Department of Interventional Cardiology, Erasmus University Medical Centre, Thoraxcenter, Rotterdam, The Netherlands.
Erhan
E
Tenekecioglu
Department of Interventional Cardiology, Erasmus University Medical Centre, Thoraxcenter, Rotterdam, The Netherlands.
Yaping
Y
Zeng
Department of Interventional Cardiology, Erasmus University Medical Centre, Thoraxcenter, Rotterdam, The Netherlands.
Yoshinobu
Y
Onuma
Barts Heart Centre, Barts Health NHS Trust, London, UK.
Anthony
A
Mathur
Barts Heart Centre, Barts Health NHS Trust, London, UK.|Department of Cardiovascular Sciences, University College London, UK.
Christos V
CV
Bourantas
D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization / Q000379:methods; D057791:Cardiac Imaging Techniques / Q000639:trends*; D000072226:Computed Tomography Angiography / Q000379:methods; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D005240:Feasibility Studies; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000473:pathology; D012680:Sensitivity and Specificity; D019265:Spectroscopy, Near-Infrared; D041623:Tomography, Optical Coherence / Q000639:trends; D018084:Ultrasonography, Interventional / Q000379:methods
atherosclerosis ; multimodality imaging ; vulnerable plaque