Intracoronary near-infrared spectroscopy (NIRS) can identify lipid in the coronary arteries, but lacks depth resolution. A
novel catheter is currently in clinical use that combines NIRS with intravascular ultrasound (IVUS), which provides
depth-resolved structural information via the IVUS modality. A measure designated as lipid-rich plaque burden (LRPB)
has been proposed as a means to interpret the combined acoustic and optical information of NIRS-IVUS. LRPB is
defined as the area created by the intersection of the NIRS lipid-rich arc with the corresponding IVUS-measured plaque
burden. We determined the correlation in human coronary autopsy specimens between LRPB, a measure of lipid
presence and extent available via intravascular imaging in patients, and the area of lipid-rich plaque as determined by the
gold-standard of histology.
Fifteen artery segments from 8 human autopsy hearts were imaged with the NIRS-IVUS system (TVC Imaging System,
Infraredx Inc., Burlington, MA). Arteries were imaged in a specialty fixture that assured accurate co-registration
between imaging and histology. The arteries were then fixed and divided into 2 mm blocks for histological staining.
Pathological contouring of lipid-rich areas was performed on the stained thin sections for 54 lipid-rich blocks.
Computation of LRPB was performed on transverse NIRS-IVUS frames corresponding to the histologic sections. The
quantified LRPB was frequently higher than the lipid-rich plaque area determined by histology, because the region
denoted by the EEL and lumen within the NIRS lipid-rich arc is not entirely comprised of lipid. Overall, a moderate to
strong correlation (R = 0.73) was found between LRPB determined by NIRS-IVUS imaging and the lipid-rich plaque
area determined by histology. LRPB, which can be measured in patients with NIRS-IVUS imaging, corresponds to the
amount of lipid-rich plaque in a coronary artery. LRPB should be evaluated in prospective clinical trials for its ability to
identify vulnerable plaques.
Jimmy L. Su, Stephanie J. Grainger, Cherry A. Greiner, Michael J. Hendricks, Meghan M. Goode, Matthew D. Saybolt M.D., Robert L. Wilensky M.D., Sean P. Madden, and James E. Muller M.D., "Evaluation of combined near-IR spectroscopic (NIRS)-IVUS imaging as a means to detect lipid-rich plaque burden in human coronary autopsy specimens," Proc. SPIE 9689, Photonic Therapeutics and Diagnostics XII, 96892V (Presented at SPIE BiOS: February 13, 2016; Published: 29 February 2016); https://doi.org/10.1117/12.2209701.
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