Diagnostic accuracy of optical coherence tomography and intravascular ultrasound for the detection and characterization of atherosclerotic plaque composition in ex-vivo coronary specimens

A comparison with histology

Johannes Rieber, Oliver Meissner, Gregor Babaryka, Susanne Reim, Melanie Oswald, Andreas Koenig, Thomas M. Schiele, Michael Shapiro, Karl Theisen, Maximilian F. Reiser, Volker Klauss, Udo Hoffmann

Research output: Contribution to journalArticle

83 Citations (Scopus)

Abstract

BACKGROUND: Both intravascular ultrasound and optical coherence tomography have been purported to accurately detect and characterize coronary atherosclerotic plaque composition. The aim of our study was to directly compare the reproducibility and diagnostic accuracy of optical coherence tomography and intravascular ultrasound for the detection and characterization of coronary plaque composition ex vivo as compared with histology. METHODS AND RESULTS: Intravascular ultrasound (20 MHz) and optical coherence tomography imaging was performed in eight heart specimens using motorized pullback. Standard histology using hematoxylin-eosin and van Gieson staining was performed on 4 μm thick slices. Each slice was divided into quadrants and accurately matched cross-sections were analyzed for the presence of fibrous, lipid-rich, and calcified coronary plaque using standard definitions for both intravascular ultrasound and optical coherence tomography and correlated with histology. After exclusion of 145/468 quadrants, we analyzed the remaining 323 quadrants with excellent image quality in each procedure. Optical coherence tomography demonstrated a sensitivity and specificity of 91/88% for normal wall, 64/88% for fibrous plaque, 77/94% for lipid-rich plaque, and 67/97% for calcified plaque as compared with histology. Intravascular ultrasound demonstrated a sensitivity and specificity of 55/79% for normal wall, 63/59% for fibrous plaque, 10/96% for lipid-rich plaque, and 76/98% for calcified plaque. Both intravascular ultrasound and optical coherence tomography demonstrated excellent intraobserver and interobserver agreement (optical coherence tomography: κ=0.90, κ=0.82; intravascular ultrasound: κ=0.87, κ=0.86). CONCLUSION: Optical coherence tomography is superior to intravascular ultrasound for the detection and characterization of coronary atherosclerotic plaque composition, specifically for the differentiation of noncalcified, lipid-rich, or fibrous plaque.

Original languageEnglish (US)
Pages (from-to)425-430
Number of pages6
JournalCoronary Artery Disease
Volume17
Issue number5
DOIs
StatePublished - Aug 2006
Externally publishedYes

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Optical Coherence Tomography
Atherosclerotic Plaques
Histology
Lipids
Sensitivity and Specificity
Hematoxylin
Eosine Yellowish-(YS)
Staining and Labeling

Keywords

  • Atherosclerosis
  • Histology
  • Intravascular ultrasound
  • Optical coherence tomography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Diagnostic accuracy of optical coherence tomography and intravascular ultrasound for the detection and characterization of atherosclerotic plaque composition in ex-vivo coronary specimens : A comparison with histology. / Rieber, Johannes; Meissner, Oliver; Babaryka, Gregor; Reim, Susanne; Oswald, Melanie; Koenig, Andreas; Schiele, Thomas M.; Shapiro, Michael; Theisen, Karl; Reiser, Maximilian F.; Klauss, Volker; Hoffmann, Udo.

In: Coronary Artery Disease, Vol. 17, No. 5, 08.2006, p. 425-430.

Research output: Contribution to journalArticle

Rieber, Johannes ; Meissner, Oliver ; Babaryka, Gregor ; Reim, Susanne ; Oswald, Melanie ; Koenig, Andreas ; Schiele, Thomas M. ; Shapiro, Michael ; Theisen, Karl ; Reiser, Maximilian F. ; Klauss, Volker ; Hoffmann, Udo. / Diagnostic accuracy of optical coherence tomography and intravascular ultrasound for the detection and characterization of atherosclerotic plaque composition in ex-vivo coronary specimens : A comparison with histology. In: Coronary Artery Disease. 2006 ; Vol. 17, No. 5. pp. 425-430.
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T1 - Diagnostic accuracy of optical coherence tomography and intravascular ultrasound for the detection and characterization of atherosclerotic plaque composition in ex-vivo coronary specimens

T2 - A comparison with histology

AU - Rieber, Johannes

AU - Meissner, Oliver

AU - Babaryka, Gregor

AU - Reim, Susanne

AU - Oswald, Melanie

AU - Koenig, Andreas

AU - Schiele, Thomas M.

AU - Shapiro, Michael

AU - Theisen, Karl

AU - Reiser, Maximilian F.

AU - Klauss, Volker

AU - Hoffmann, Udo

PY - 2006/8

Y1 - 2006/8

N2 - BACKGROUND: Both intravascular ultrasound and optical coherence tomography have been purported to accurately detect and characterize coronary atherosclerotic plaque composition. The aim of our study was to directly compare the reproducibility and diagnostic accuracy of optical coherence tomography and intravascular ultrasound for the detection and characterization of coronary plaque composition ex vivo as compared with histology. METHODS AND RESULTS: Intravascular ultrasound (20 MHz) and optical coherence tomography imaging was performed in eight heart specimens using motorized pullback. Standard histology using hematoxylin-eosin and van Gieson staining was performed on 4 μm thick slices. Each slice was divided into quadrants and accurately matched cross-sections were analyzed for the presence of fibrous, lipid-rich, and calcified coronary plaque using standard definitions for both intravascular ultrasound and optical coherence tomography and correlated with histology. After exclusion of 145/468 quadrants, we analyzed the remaining 323 quadrants with excellent image quality in each procedure. Optical coherence tomography demonstrated a sensitivity and specificity of 91/88% for normal wall, 64/88% for fibrous plaque, 77/94% for lipid-rich plaque, and 67/97% for calcified plaque as compared with histology. Intravascular ultrasound demonstrated a sensitivity and specificity of 55/79% for normal wall, 63/59% for fibrous plaque, 10/96% for lipid-rich plaque, and 76/98% for calcified plaque. Both intravascular ultrasound and optical coherence tomography demonstrated excellent intraobserver and interobserver agreement (optical coherence tomography: κ=0.90, κ=0.82; intravascular ultrasound: κ=0.87, κ=0.86). CONCLUSION: Optical coherence tomography is superior to intravascular ultrasound for the detection and characterization of coronary atherosclerotic plaque composition, specifically for the differentiation of noncalcified, lipid-rich, or fibrous plaque.

AB - BACKGROUND: Both intravascular ultrasound and optical coherence tomography have been purported to accurately detect and characterize coronary atherosclerotic plaque composition. The aim of our study was to directly compare the reproducibility and diagnostic accuracy of optical coherence tomography and intravascular ultrasound for the detection and characterization of coronary plaque composition ex vivo as compared with histology. METHODS AND RESULTS: Intravascular ultrasound (20 MHz) and optical coherence tomography imaging was performed in eight heart specimens using motorized pullback. Standard histology using hematoxylin-eosin and van Gieson staining was performed on 4 μm thick slices. Each slice was divided into quadrants and accurately matched cross-sections were analyzed for the presence of fibrous, lipid-rich, and calcified coronary plaque using standard definitions for both intravascular ultrasound and optical coherence tomography and correlated with histology. After exclusion of 145/468 quadrants, we analyzed the remaining 323 quadrants with excellent image quality in each procedure. Optical coherence tomography demonstrated a sensitivity and specificity of 91/88% for normal wall, 64/88% for fibrous plaque, 77/94% for lipid-rich plaque, and 67/97% for calcified plaque as compared with histology. Intravascular ultrasound demonstrated a sensitivity and specificity of 55/79% for normal wall, 63/59% for fibrous plaque, 10/96% for lipid-rich plaque, and 76/98% for calcified plaque. Both intravascular ultrasound and optical coherence tomography demonstrated excellent intraobserver and interobserver agreement (optical coherence tomography: κ=0.90, κ=0.82; intravascular ultrasound: κ=0.87, κ=0.86). CONCLUSION: Optical coherence tomography is superior to intravascular ultrasound for the detection and characterization of coronary atherosclerotic plaque composition, specifically for the differentiation of noncalcified, lipid-rich, or fibrous plaque.

KW - Atherosclerosis

KW - Histology

KW - Intravascular ultrasound

KW - Optical coherence tomography

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