Tissue Characterization of Coronary Plaques and Assessment of Thickness of Fibrous Cap Using Integrated Backscatter Intravascular Ultrasound: Comparison With Histology and Optical Coherence Tomography

Background: The purpose of this study was to develop a new online integrated backscatter intravascular ultrasound (IB-IVUS) system and to validate its ability to measure fibrous cap thickness by comparing IB-IVUS images with those from optical coherence tomography (OCT). Methods and Results: Images...

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Bibliographic Details
Published in:Circulation Journal 2010, Vol.74(12), pp.2641-2648
Main Authors: Kawasaki, Masanori, Hattori, Arihiro, Ishihara, Yoshiyuki, Okubo, Munenori, Nishigaki, Kazuhiko, Takemura, Genzou, Saio, Masanao, Takami, Tsuyoshi, Minatoguchi, Shinya
Format: Article
Language:English
Subjects:
Angina Pectoris - pathology
Calcinosis - pathology
Coronary plaque
Female
Fibrous cap
Humans
Integrated backscatter
Intravascular ultrasound
Male
Optical coherence tomography
Tomography, Optical Coherence - methods
Ultrasonography, Interventional - methods
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Summary:Background: The purpose of this study was to develop a new online integrated backscatter intravascular ultrasound (IB-IVUS) system and to validate its ability to measure fibrous cap thickness by comparing IB-IVUS images with those from optical coherence tomography (OCT). Methods and Results: Images were acquired from 125 segments of 26 coronary arteries obtained at autopsy from 11 cadavers. In the training study (n=30), 242 regions-of-interest on color-coded maps were compared with histology. In the validation study, 95 cross-sections were diagnosed by IB-IVUS and histology. In 24 patients with stable angina, 28 arterial cross-sections were imaged by IB-IVUS and OCT in vivo. In the training study, cutoff values of 39 decibels (dB) and 17dB were the optimal predictors of lipid pool/fibrosis and fibrosis/calcification, respectively, with 38-MHz mode; 42dB and 20dB, respectively, with 43-MHz mode. In the validation study, IB classified the fibrous, lipid-rich and fibrocalcific components with an accuracy of 92%, 91% and 95%, respectively. Agreement between the histological and IB-IVUS diagnoses was excellent (Cohen's κ=0.83). There was a correlation between the fibrous cap thickness measured by IB-IVUS and OCT (r=0.74, P
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-10-0547