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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

View larger version (118K): [in a new window]   Figure 1 Corresponding cross section of each imaging modality. Regions of interest (0.2 mm x 0.2 mm) were randomly set on each image (red squares). (A) Histological image (Masson's trichrome staining). (B) Optical coherence tomography image. (C) Conventional intravascular ultrasound image. (D) Integrated backscatter intravascular ultrasound image. The lipid pool was detected by histology (arrowhead in A). The same lipid pool was detected by optical coherence tomography as a homogenous, diffusely bordered, signal-poor region (arrowhead in B) and detected by integrated backscatter intravascular ultrasound as the blue area (arrowhead in D). The lipid pool could not be clearly discriminated by conventional intravascular ultrasound. CL = calcification. Bar = 1 mm.

View larger version (109K): [in a new window]   Figure 2 Example of a discrepancy between the optical coherence tomography and integrated backscatter intravascular ultrasound diagnosis. (A) Histological image (Masson's trichrome staining). (B) Optical coherence tomography image. (C) Conventional intravascular ultrasound image. (D) Integrated backscatter intravascular ultrasound image. A fibrous lesion was detected by optical coherence tomography as a homogeneous, highly backscattering (signal-rich) region (arrowhead in B). However, the fibrous lesion was misclassified as intimal hyperplasia by the integrated backscatter intravascular ultrasound image (arrowhead in D) because the fibrous lesion consisted of fibrosis with minimal collagen fiber. CL = calcification. Bar = 1 mm.