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Imaging assessment and accuracy in coronary artery autopsy: comparison of frequency-domain optical coherence tomography with intravascular ultrasound and histology

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Abstract

Optical coherence tomography (OCT) is a coronary artery imaging technique with high resolution. Second-generation frequency-domain OCT (FD-OCT) technology allows safer and faster clinical application compared with first-generation time-domain OCT (TD-OCT). Only limited validation studies compare FD-OCT with other modes of analysis: histology, which is the current gold standard, and intravascular ultrasound (IVUS). This study therefore aims to demonstrate the accuracy of FD-OCT images compared with IVUS and histology. FD-OCT and IVUS images were acquired from 203 segments from 31 coronary arteries obtained at autopsy from 20 cadavers. Of these, 30 randomly-selected pairs were used to create three classifications of plaque type based on morphological features in FD-OCT and IVUS compared with corresponding histopathology. The remaining 173 pairs were used to demonstrate the diagnostic accuracy for classification of coronary plaques by FD-OCT. Plaque type distributions were 27% fibroatheroma, 22% fibrocalcific plaque and 51% fibrous plaque. The diagnostic accuracies of FD-OCT for fibroatheroma, fibrocalcific plaque and fibrous plaque were 90, 95 and 93%, respectively. Those of IVUS were 81, 89 and 84%, respectively. FD-OCT achieved high diagnostic accuracy for the classification of coronary plaques comparable to TD-OCT. Physicians should consider the differences in the ability to classify plaque morphology of OCT of imaging devices when applying their use.

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Acknowledgements

The authors would like to thank Mayumi Akira for technical assistance and Yasuteru Muragaki, Department of Pathology and Shin-ichi Murata, Department of Human Pathology, Wakayama Medical University, Wakayama, Japan, for their valuable advice regarding the pathological aspects of this work. We acknowledge proofreading by Benjamin Phillis, Clinical Study Support Center, Wakayama Medical University.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Japan

    Aiko Shimokado, Takashi Kubo, Yoshiki Matsuo, Yasushi Ino, Yasutsugu Shiono, Kunihiro Shimamura, Yosuke Katayama, Akira Taruya, Tsuyoshi Nishiguchi, Manabu Kashiwagi, Hironori Kitabata, Atsushi Tanaka, Takeshi Hozumi & Takashi Akasaka

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  1. Aiko Shimokado
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  2. Takashi Kubo
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  3. Yoshiki Matsuo
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  4. Yasushi Ino
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  5. Yasutsugu Shiono
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Correspondence to Takashi Kubo.

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Conflict of interest

Takashi Kubo has received lecture fees from Abbott Vascular. Yasutsugu Shiono received lecture fees from Abbott Vascular. T. Akasaka has received lecture fees from Abbott Vascular and Boston Scientific, and research grants from Abbott Vascular. No other authors have relationships to disclose relevant to the contents of this paper.

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Shimokado, A., Kubo, T., Matsuo, Y. et al. Imaging assessment and accuracy in coronary artery autopsy: comparison of frequency-domain optical coherence tomography with intravascular ultrasound and histology. Int J Cardiovasc Imaging 35, 1785–1790 (2019). https://doi.org/10.1007/s10554-019-01639-0

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  • DOI: https://doi.org/10.1007/s10554-019-01639-0

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