Author + information
- Received January 4, 2006
- Revision received February 21, 2006
- Accepted February 27, 2006
- Published online July 4, 2006.
- 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⁎
- ↵⁎Reprint requests and correspondence:
Dr. Masanori Kawasaki, Wellman Laboratories of Photomedicine, Massachusetts General Hospital and Harvard Medical School, 40 Blossom Street, Boston, Massachusetts 02114.
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 κ = 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 κ = 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 κ = 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.
This study was supported by the Banyu Fellowship Awards in Cardiovascular Medicine, which are sponsored by Banyu Pharmaceutical Co. Ltd. and The Merck Company Foundation.
- Received January 4, 2006.
- Revision received February 21, 2006.
- Accepted February 27, 2006.
- American College of Cardiology Foundation