This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: j.jacc.2006.02.062v1 48/1/81    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kawasaki, M. Articles by Tearney, G. J. Search for Related Content PubMed PubMed Citation Articles by Kawasaki, M. Articles by Tearney, G. J.

CLINICAL RESEARCH: CORONARY ARTERY DISEASE

Diagnostic Accuracy of Optical Coherence Tomography and Integrated Backscatter Intravascular Ultrasound Images for Tissue Characterization of Human Coronary Plaques

Masanori Kawasaki, MD, PhD^_*,_*, Brett E. Bouma, PhD^_*, Jason Bressner, PhD^_*, Stuart L. Houser, MD, Seemantini K. Nadkarni, PhD^_*, Briain D. MacNeill, MD, Ik-Kyung Jang, MD, PhD, Hisayoshi Fujiwara, MD, PhD and Guillermo J. Tearney, MD, PhD^_*

^_* Wellman Laboratories of Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
Regeneration and Advanced Medical Science, Gifu University Graduate School of Medicine, Gifu, Japan.

Manuscript received January 4, 2006; revised manuscript received February 21, 2006, accepted February 27, 2006.

^_* Reprint requests and correspondence: Dr. Masanori Kawasaki, Wellman Laboratories of Photomedicine, Massachusetts General Hospital and Harvard Medical School, 40 Blossom Street, Boston, Massachusetts 02114. (Email: masanori{at}ya2.so-net.ne.jp).

OBJECTIVES: The purpose of the present study was to validate the diagnostic accuracy of optical coherence tomography (OCT), integrated backscatter intravascular ultrasound (IB-IVUS), and conventional intravascular ultrasound (C-IVUS) for tissue characterization of coronary plaques and to evaluate the advantages and limitations of each of these modalities.

BACKGROUND: The diagnostic accuracy of OCT for characterizing tissue types is well established. However, comparisons among OCT, C-IVUS, and IB-IVUS have not been done.

METHODS: We examined 128 coronary arterial sites (42 coronary arteries) from 17 cadavers; IVUS and OCT images were acquired on the same slice as histology. Ultrasound signals were obtained using an IVUS system with a 40-MHz catheter and digitized at 1 GHz with 8-bit resolution. The IB values of the ultrasound signals were calculated with a fast Fourier transform.

RESULTS: Using histological images as a gold standard, the sensitivity of OCT for characterizing calcification, fibrosis, and lipid pool was 100%, 98%, and 95%, respectively. The specificity of OCT was 100%, 94%, and 98%, respectively (Cohen’s = 0.92). The sensitivity of IB-IVUS was 100%, 94%, and 84%, respectively. The specificity of IB-IVUS was 99%, 84%, and 97%, respectively (Cohen’s = 0.80). The sensitivity of C-IVUS was 100%, 93%, and 67%, respectively. The specificity of C-IVUS was 99%, 61%, and 95%, respectively (Cohen’s = 0.59).

CONCLUSIONS: Within the penetration depth of OCT, OCT has a best potential for tissue characterization of coronary plaques. Integrated backscatter IVUS has a better potential for characterizing fibrous lesions and lipid pools than C-IVUS.

Abbreviations and Acronyms   C-IVUS = conventional intravascular ultrasound   CI = confidence interval   IB = integrated backscatter   IVUS = intravascular ultrasound   OCT = optical coherence tomography   ROI = region of interest

This article has been cited by other articles:

				O C Raffel, T Akasaka, and I-K Jang Cardiac optical coherence tomography Heart, September 1, 2008; 94(9): 1200 - 1210. [Full Text] [PDF]

				S. K. Mehta, J. R. McCrary, A. D. Frutkin, W. J.S. Dolla, and S. P. Marso Intravascular ultrasound radiofrequency analysis of coronary atherosclerosis: an emerging technology for the assessment of vulnerable plaque Eur. Heart J., June 1, 2007; 28(11): 1283 - 1288. [Abstract] [Full Text] [PDF]