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An assessment of the quality of optical coherence tomography image acquisition

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Abstract

Optical coherence tomography (OCT) provides excellent image resolution, however OCT optimal acquisition is essential but could be challenging owing to several factors. We sought to assess the quality of OCT pullbacks and identify the causes of suboptimal image acquisition. We evaluated 784 (404 pre-PCI; 380 post-PCI) coronary pullbacks from an anonymized OCT database from our Cardiovascular Imaging Core Laboratory. Imaging of the region-of-interest (ROI—lesion or stented segment plus references) was incomplete in 16.1% pullbacks, caused by pullback starting too proximal (63.7%), inappropriate pullback length (17.1%) and pullback starting too distal (11.4%). The quality of image acquisition was excellent in 36.3% pullbacks; whereas 4% pullbacks were unanalyzable. Pullback quality was most commonly affected by poor blood displacement from inadequate contrast volume (27.4%) or flow (25.6%), followed by artifacts (24.1%). Acquisition mode was ‘High-Resolution’ (54 mm) in 74.4% and ‘Survey’ (75 mm) in 25.6% of cases. The 54 mm mode was associated with incomplete ROI imaging (p = 0.020) and inadequate contrast volume (p = 0.035). We observed a substantial frequency of suboptimal image acquisition and identified its causes, most of which can be addressed with minor modifications during the procedure, ultimately improving patient outcomes.

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Abbreviations

OCT:

Optical coherence tomography

LAD:

Left anterior descending

ROI:

Region of interest

PCI:

Percutaneous coronary intervention

CIL:

Clear imaging length

CSL:

Clear stent length

STEMI:

ST segment elevation myocardial infarction

CTO:

Chronic total occlusion

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Authors and Affiliations

  1. Cardiovascular Imaging Core Laboratory, Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside Building, Room 3113, Mailstop: Lakeside 5038, Cleveland, OH, 44106, USA

    Elder Iarossi Zago, Abdul Jawwad Samdani, Gabriel Tensol Rodrigues Pereira, Armando Vergara-Martel, Luis Augusto Dallan, Patricia Ely Pizzato, Vladislav Zimin, Anas Fares & Hiram G. Bezerra

  2. University of Texas Southwestern, Dallas, TX, USA

    Mohamad Amer Alaiti

  3. VA North Texas Healthcare System, Dallas, TX, USA

    Mohamad Amer Alaiti

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  1. Elder Iarossi Zago
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Correspondence to Elder Iarossi Zago.

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Dr. Bezerra receives consulting fees from Abbott Vascular, Inc. Other authors report no relevant conflicts of interest.

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Iarossi Zago, E., Samdani, A.J., Pereira, G.T.R. et al. An assessment of the quality of optical coherence tomography image acquisition. Int J Cardiovasc Imaging 36, 1013–1020 (2020). https://doi.org/10.1007/s10554-020-01795-8

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