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 journalArticlepeer-review

    89 Scopus citations

    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

    Keywords

    • Atherosclerosis
    • Histology
    • Intravascular ultrasound
    • Optical coherence tomography

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine

    Fingerprint

    Dive into the research topics of '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'. Together they form a unique fingerprint.

    Cite this