Feasibility of optical coronary tomography in quantitative measurement of coronary arteries with lipid-rich plaque

Abstract

Background: The aim of the present study was to evaluate the feasibility of optical coherence tomography (OCT) for measurement of vessel area in coronary arteries with lipid-rich plaque as compared with intravascular ultrasound (IVUS). Methods and Results: We investigated 80 coronary artery segments with lipid-rich plaque on OCT and non-attenuated plaque on IVUS. According to the lipid arc on OCT, the plaques were classified into 4 groups: group 1, lipid arc ≤90°; group 2, 90° 270°. Vessel circular arcs that could not be identified due to OCT signal attenuation were interpolated using an approximating algorithm. OCTmeasured vessel area was well-correlated with IVUS-measured vessel area (R=0.834, P<0.001). On Bland-Altman plot, there was a good agreement between OCT-measured vessel area and IVUS-measured vessel area, although mean difference and limits of agreement increased with increase of lipid arc (mean difference in groups 1–4: –0.21, –0.31, –1.02, and –2.13 mm2; lower limit: –1.49, –3.22, –5.24, and –9.25 mm2; and upper limit: 1.07, 2.60, 3.20, and 4.99 mm2). Intra-observer (R=0.97–0.99, P<0.001) and inter-observer (R=0.97–0.99, P<0.001) reproducibility for OCT measurement of vessel area was excellent. Conclusions: Like IVUS, OCT can be used to measure vessel area in coronary arteries with lipid-rich plaque.