In vivo characterisation of coronary plaques with conventional grey-scale intravascular ultrasound: correlation with optical coherence tomography.

AIMS Although intravascular ultrasound (IVUS) is widely used, there is limited published data on its accuracy in defining plaque characteristics in vivo. Optical coherence tomography (OCT) is a high-resolution imaging technique that takes advantage of the pronounced optical contrast between the components of normal and diseased vessels. The aim of this study was to evaluate the ability of conventional grey-scale IVUS in identifying in vivo coronary plaque characteristics, in particular lipid content as a marker of the vulnerable plaque, when compared to OCT. METHODS AND RESULTS In patients undergoing cardiac catheterisation, IVUS and OCT imaging was performed. Detailed qualitative analysis of lipid-rich plaque, calcific plaque, and plaque disruption were performed at corresponding sites using both modalities. A total of 146 matched sites were available for analysis. When compared to OCT, sensitivity of IVUS for identification of lipid pools was low (24.1%) but specificity was high (93.9%). The sensitivity and specificity of IVUS for detection of calcific plaque and plaque disruption were respectively 92.9%; 66.4%, and 66.7%; 96.1%. CONCLUSIONS Conventional grey-scale IVUS may not be a reliable imaging modality for detection of lipid-rich and hence vulnerable plaques. This has important implications in using conventional grey-scale IVUS to identify the vulnerable plaque.

[1]  Takashi Akasaka,et al.  Assessment of culprit lesion morphology in acute myocardial infarction: ability of optical coherence tomography compared with intravascular ultrasound and coronary angioscopy. , 2007, Journal of the American College of Cardiology.

[2]  E. Boerwinkle,et al.  From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: Part I. , 2003, Circulation.

[3]  H. Fujita,et al.  Assessment of vulnerable plaques causing acute coronary syndrome using integrated backscatter intravascular ultrasound. , 2006, Journal of the American College of Cardiology.

[4]  Zahi A Fayad,et al.  Acute coronary syndromes: biology , 1999, The Lancet.

[5]  N Bom,et al.  Characterization of plaque components with intravascular ultrasound elastography in human femoral and coronary arteries in vitro. , 2000, Circulation.

[6]  P. Serruys,et al.  Characterizing Vulnerable Plaque Features With Intravascular Elastography , 2003, Circulation.

[7]  C T Lancée,et al.  Arterial wall characteristics determined by intravascular ultrasound imaging: an in vitro study. , 1989, Journal of the American College of Cardiology.

[8]  R. Virmani,et al.  Accuracy of in vivo coronary plaque morphology assessment: a validation study of in vivo virtual histology compared with in vitro histopathology. , 2006, Journal of the American College of Cardiology.

[9]  Eloisa Arbustini,et al.  Sources of error and interpretation of plaque morphology by optical coherence tomography. , 2006, The American journal of cardiology.

[10]  W N McDicken,et al.  In vitro analysis of coronary atheromatous lesions by intravascular ultrasound; reproducibility and histological correlation of lesion morphology. , 1999, European heart journal.

[11]  C. Tracy,et al.  American College of Cardiology Clinical Expert Consensus Document on Standards for Acquisition, Measurement and Reporting of Intravascular Ultrasound Studies (IVUS). A report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents. , 2001, Journal of the American College of Cardiology.

[12]  Brett E. Bouma,et al.  In Vivo Characterization of Coronary Atherosclerotic Plaque by Use of Optical Coherence Tomography , 2005, Circulation.

[13]  Antonio Colombo,et al.  From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: Part II. , 2003, Circulation.

[14]  E. Halpern,et al.  Characterization of Human Atherosclerosis by Optical Coherence Tomography , 2002, Circulation.

[15]  F Prati,et al.  Correlation between high frequency intravascular ultrasound and histomorphology in human coronary arteries , 2001, Heart.

[16]  S E Nissen,et al.  Extent and direction of arterial remodeling in stable versus unstable coronary syndromes : an intravascular ultrasound study. , 2000, Circulation.

[17]  R. Virmani,et al.  Coronary risk factors and plaque morphology in men with coronary disease who died suddenly. , 1997, The New England journal of medicine.

[18]  Jagat Narula,et al.  Imaging vulnerable plaque by ultrasound. , 2006, Journal of the American College of Cardiology.

[19]  K. Seung,et al.  Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography: comparison with intravascular ultrasound. , 2002, Journal of the American College of Cardiology.

[20]  Eiji Toyota,et al.  Assessment of coronary arterial plaque by optical coherence tomography. , 2006, The American journal of cardiology.

[21]  S. Yun,et al.  High-speed spectral-domain optical coherence tomography at 1.3 mum wavelength. , 2003, Optics express.

[22]  Valentin Fuster,et al.  Intravascular Modalities for Detection of Vulnerable Plaque: Current Status , 2003, Arteriosclerosis, thrombosis, and vascular biology.

[23]  S. Yun,et al.  High-speed optical frequency-domain imaging. , 2003, Optics express.

[24]  M. Matsuzaki,et al.  Detection of lipid-laden atherosclerotic plaque by wavelet analysis of radiofrequency intravascular ultrasound signals: in vitro validation and preliminary in vivo application. , 2005, Journal of the American College of Cardiology.

[25]  J. Fujimoto,et al.  Assessment of coronary plaque with optical coherence tomography and high-frequency ultrasound. , 2000, The American journal of cardiology.

[26]  Patrick W Serruys,et al.  Multi-modality intra-coronary plaque characterization: a pilot study. , 2010, International journal of cardiology.

[27]  P. Stone,et al.  Circadian variation and triggers of onset of acute cardiovascular disease. , 1989, Circulation.

[28]  S. Nakatani,et al.  Morphology of vulnerable coronary plaque: insights from follow-up of patients examined by intravascular ultrasound before an acute coronary syndrome. , 2000, Journal of the American College of Cardiology.

[29]  Walter L. Henry,et al.  Intravascular Ultrasound Imaging of Human Coronary Arteries In Vivo: Analysis of Tissue Characterizations With Comparison to In Vitro Histological Specimens , 1991, Circulation.

[30]  E. Tuzcu,et al.  Coronary Plaque Classification With Intravascular Ultrasound Radiofrequency Data Analysis , 2002, Circulation.