Abstract
The region behind the coronary calcium could not be visualized by intravascular ultrasound (IVUS) because of acoustic shadow. However, some pathological studies have shown that IVUS delineated the vessel border behind thin coronary calcium sheets. This study aimed to reveal whether recent IVUS can visualize the region behind thin coronary calcium sheets. Using 534 cross-sectional optical frequency domain images (OFDI), including severe calcified coronary lesions, calcium sheet thickness was measured by every 1°. Accordingly, the visibility of the vessel border behind the coronary calcium sheet was evaluated using 60-MHz IVUS images, which were longitudinally linked with OFDI ones. After carefully coordinating with the axial position, the association between the IVUS-derived permeability of the coronary calcium sheet and calcium thickness was evaluated. The maximum and mean calcium thickness by OFDI was 0.88 ± 0.39 and 0.62 ± 0.30 mm, respectively. By 60-MHz IVUS, 12.1% of the coronary calcium sheets had permeable segments. Comparing between OFDI and IVUS images, 48.6% of the coronary calcium sheets with maximum thickness ≤ 0.3 mm were sometimes permeable by 60-MHz IVUS, whereas most > 0.5 mm thick calcium sheets were impermeable. In the receiver operating characteristic curve analysis, the best cutoff values for the maximum and mean thickness of permeable calcium were 0.48 and 0.31 mm, respectively. Thus, 60-MHz IVUS can occasionally visualize the region behind a thin coronary calcium sheet. When using 60-MHz IVUS, this finding may be a predictive marker of calcium sheet with a thickness of < 0.5 mm.
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Acknowledgements
This work was supported by KAKENHI Grant Number 20K08142 from the Japan Society for the Promotion of Science (JSPS).
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This work was supported by KAKENHI Grant No. 20K08142 from the Japan Society for the Promotion of Science (JSPS).
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All authors contributed to the study conception and design. Yuya Oshikiri, Masaru Ishida, Ryohei Sakamoto, Takumi Kimura, Yudai Shimoda, Yorihiko Koeda, Ryutaro Shimada, Tomonori Itoh, and Yoshihiro Morino contributed to material preparation, data collection, and analysis. Yuya Oshikiri wrote the first draft of the manuscript, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Dr. Ishida has received lecture honoraria from Abbott Medical Japan, Boston Scientific Japan, Medikit, Shockwave Medical Japan, and Terumo Corporation. Dr. Itoh has received lecture honoraria from Abbott Medical Japan. Dr. Morino has received lecture honoraria and unrestricted research funding from Abbott Medical Japan, Boston Scientific, and Terumo Corporation.
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Dr. Ishida has received lecture honoraria from Abbott Medical Japan, Boston Scientific Japan, Medikit, Shockwave Medical Japan, and Terumo Corporation. Dr. Itoh has received lecture honoraria from Abbott Medical Japan. Dr. Morino has received lecture honoraria and unrestricted research funding from Abbott Medical Japan, Boston Scientific, and Terumo Corporation.
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This study was performed in line with the principles of the Declaration of Helsinki. The study was approved by the ethics committees at each participating institution (November 12, 2019, MH2019-125).
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Oshikiri, Y., Ishida, M., Sakamoto, R. et al. Evaluation of the thickness of coronary calcium by 60-MHz intravascular ultrasound: head-to-head comparison with optical frequency domain imaging. Int J Cardiovasc Imaging 39, 2599–2607 (2023). https://doi.org/10.1007/s10554-023-02955-2
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DOI: https://doi.org/10.1007/s10554-023-02955-2