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29 February 2016 Evaluation of combined near-IR spectroscopic (NIRS)-IVUS imaging as a means to detect lipid-rich plaque burden in human coronary autopsy specimens
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Abstract
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.
Conference Presentation
© (2016) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.
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 (29 February 2016); https://doi.org/10.1117/12.2209701
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