CLINICAL RESEARCH
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
Department of Pathology
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.
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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 |
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