Development of integrated multimodality intravascular imaging system for assessing and characterizing atherosclerosis

Abstract

Atherosclerosis is one of the major causes of morbidity and mortality in developed countries. Early detection of plaque lesions is the first and most necessary step towards preventing the lethal consequences of atherosclerosis. Currently, many biomedical imaging techniques aimed at imaging and assessing vulnerable plaques have been reported in literature. Unfortunately, atherosclerosis is often asymptomatic, as vulnerable plaques grow without causing any detrimental side effects until rupturing. Due to this complication, the information provided by a single clinical arterial imaging technique is often insufficient to diagnose vulnerable plaque formation at an early stage. Therefore, an optimal imaging modality for diagnosis and characterization of plaques should combine high spatial resolution capable of resolving fibrous cap thickness, deep imaging depth capable of assessing plaque burden and vessel remodeling, and molecular sensitivity capable of determining tissue composition and mechanical properties. This chapter describes several multimodality intravascular imaging systems that integrate intravascular OCT with ultrasound (US), fluorescence, and elastography. The integrated multimodality intravascular imaging system can measure vascular tissue with high imaging resolution and deep imaging depth, chemical composition, and tissue mechanical properties simultaneously. The system will provide an interventional cardiologist with a critically important tool for detecting and characterizing vulnerable plaques, monitoring the progression of disease, and evaluating the efficacy of intervention. The surveillance and early diagnosis of vulnerable lesions will prove to be of the utmost importance in further efforts to tailor therapeutic interventions towards patients at risk. Several multimodality intravascular imaging systems, including intravascular OCT/US, OCT/fluorescence, and OCT/phase resolved acoustic radiation force optical coherence elastography will be discussed.