Optical coherence tomography attenuation imaging for lipid core detection
an ex-vivo validation study
Muthukaruppan Gnanadesigan (Erasmus MC)
Ali S. Hussain (Bristol Heart Institute)
Stephen White (University of Bristol)
Simon Scoltock (University of Bristol)
Andreas Baumbach (Bristol Heart Institute)
A. F.W. Steen (ImPhys/Acoustical Wavefield Imaging , Erasmus MC)
Evelyn Regar (Erasmus MC)
Thomas W. Johnson (Bristol Heart Institute)
Gijs Van Soest (Erasmus MC)
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Abstract
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.