Abstract
Background: Both mechanical and phased-array catheters are used in clinical trials to assess quantitative parameters. Only limited evaluation of the in vivo agreement of volumetrical measurements between such systems has been performed, despite the fact that such information is essential for the conduction of atherosclerosis regression trials. Methods and results: We prospectively evaluated the agreement in morphometric measurements and intravascular ultrasound (IVUS)-based plaque characterization between a 40 MHz rotating transducer (3.2 F Atlantis, Boston Scientific Corp.) and a 20 MHz phased-array catheter (2.9 F Eagle Eye, Volcano Therapeutics, Rancho Cordova, California) in 16 patients. Lumen (7.3 ± 2.0 mm2 vs. 6.7 ± 1.8 mm2, p = 0.001) and vessel (11.8 ± 3.3 mm2 vs. 11.0 ± 2.9 mm2, p = 0.02) cross-sectional areas (CSA) were significantly greater with the 20 MHz system. Plaque CSA measurements showed no significant difference between systems (4.4 ± 2.3 mm2 vs. 4.4 ± 2.1). The relative differences were less than 10% for the three variables. On IVUS-based tissue characterization (13 patients), calculated percentage hypoechogenic volume was significantly higher for the 20 MHz system (96.7 ± 2.38 vs. 88.4 ± 5.53, p < 0.0001). Conclusions: Quantitative IVUS analyses display significant catheter type-dependent variability. It is unclear whether the variability reflects overestimation of measurements with the phased-array or underestimation with the mechanical system. Although plaque burden measurements did not differ significantly between systems, it appears prudent to recommend the use of a single system for progression/regression studies.
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RA Nishimura, WD Edwards and CA Warnes, Intravascular ultrasound imaging: in vitro validation and pathologic correlation. J Am Coll Cardiol 16 (1990) 145-154
P Jaegere de, H Mudra and H Figulla, Intravascular ultrasound-guided optimized stent deployment. Immediate and 6 months clinical and angiographic results from the Multicenter Ultrasound Stenting in Coronaries Study (MUSIC Study). Eur Heart J 19 (1998) 1214-1223
PJ Fitzgerald, A Oshima and M Hayase, Final results of the Can Routine Ultrasound Influence Stent Expansion (CRUISE) study. Circulation 102 (2000) 523-530
Q Rasheed, PJ Dhawale, J Anderson and JM Hodgson, Intracoronary ultrasound-defined plaque composition: computer-aided plaque characterization and correlation with histologic samples obtained during directional coronary atherectomy. Am Heart J 129 (1995) 631-637
A Nair, BD Kuban, EM Tuzcu, P Schoenhagen, SE Nissen and DG Vince, Coronary plaque classification with intravascular ultrasound radiofrequency data analysis. Circulation 106 (2002) 2200-2206
M Schartl, W Bocksch and DH Koschyk, Use of intravascular ultrasound to compare effects of different strategies of lipid-lowering therapy on plaque volume and composition in patients with coronary artery disease. Circulation 104 (2001) 387-392
T Hiro, CY Leung, RJ Russo, H Karimi, AR Farvid and JM Tobis, Variability of a three-layered appearance in intravascular ultrasound coronary images: a comparison of morphometric measurements with four intravascular ultrasound systems. Am J Card Imaging 10 (1996) 219-227
T Hiro, CY Leung and RJ Russo, Variability in tissue characterization of atherosclerotic plaque by intravascular ultrasound: a comparison of four intravascular ultrasound systems. Am J Card Imaging 10 (1996) 209-218
Y Li, J Honye and S Saito, Variability in quantitative measurement of the same segment with two different intravascular ultrasound systems: in vivo and in vitro studies. Catheter Cardiovasc Interv 62 (2004) 175-180
SE Nissen and P Yock, Intravascular ultrasound: novel pathophysiological insights and current clinical applications. Circulation 103 (2001) 604-616
F Prati, E Arbustini and A Labellarte, Correlation between high frequency intravascular ultrasound and histomorphology in human coronary arteries. Heart 85 (2001) 567-570
T Okimoto, M Imazu, Y Hayashi, H Fujiwara, H Ueda and N Kohno, Atherosclerotic plaque characterization by quantitative analysis using intravascular ultrasound: correlation with histological and immunohistochemical findings. Circ J 66 (2002) 173-177
SA Winter de, I Heller and R Hamers, Computer assisted three-dimensional plaque characterization in ultracoronary ultrasound studies. Computers in Cardiology 30 (2003) 73-76
JM Bland and DG Altman, Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1 (1986) 307-310
SE Nissen, T Tsunoda and EM Tuzcu, Effect of recombinant ApoA-I Milano on coronary atherosclerosis in patients with acute coronary syndromes: a randomized controlled trial. Jama 290 (2003) 2292-2300
SE Nissen, EM Tuzcu and P Schoenhagen, Effect of intensive compared with moderate lipid-lowering therapy on progression of coronary atherosclerosis: a randomized controlled trial. Jama 291 (2004) 1071-1080
LO Jensen, P Thayssen, KE Pedersen, S Stender and T Haghfelt, Regression of coronary atherosclerosis by simvastatin: a serial intravascular ultrasound study. Circulation 110 (2004) 265-270
P Schoenhagen, SK Sapp and EM Tuzcu, Variability of area measurements obtained with different intravascular ultrasound catheter systems: Impact on clinical trials and a method for accurate calibration. J Am Soc Echocardiogr 16 (2003) 277-284
JC Tardif, OF Bertrand and R Mongrain, Reliability of mechanical and phased-array designs for serial intravascular ultrasound examinations – animal and clinical studies in stented and non-stented coronary arteries. Int J Card Imaging 16 (2000) 365-375
D Hausmann, AJ Lundkvist, GJ Friedrich, WL Mullen, PJ Fitzgerald and PG Yock, Intracoronary ultrasound imaging: intraobserver and interobserver variability of morphometric measurements. Am Heart J 128 (1994) 674-680
C Birgelen Von, M Hartmann and GS Mintz, Spectrum of remodeling behavior observed with serial long-term (≥12 months) follow-up intravascular ultrasound studies in left main coronary arteries. Am J Cardiol 93 (2004) 1107-1113
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Rodriguez-Granillo, G.A., Fadden, E.P.M., Aoki, J. et al. In vivo Variability in Quantitative Coronary Ultrasound and Tissue Characterization Measurements with Mechanical and Phased-array Catheters. Int J Cardiovasc Imaging 22, 47–53 (2006). https://doi.org/10.1007/s10554-005-6423-1
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DOI: https://doi.org/10.1007/s10554-005-6423-1