Abstract

Intravascular optical coherence tomography (IVOCT) is rapidly becoming the method of choice for the in vivo investigation of coronary artery disease. While IVOCT visualizes atherosclerotic plaques with a resolution <20µm, image analysis in terms of tissue composition is currently performed by a time-consuming manual procedure based on the qualitative interpretation of image features. We illustrate an algorithm for the automated and systematic characterization of IVOCT atherosclerotic tissue. The proposed method consists in a supervised classification of image pixels according to textural features combined with the estimated value of the optical attenuation coefficient. IVOCT images of 64 plaques, from 49 in vivo IVOCT data sets, constituted the algorithm’s training and testing data sets. Validation was obtained by comparing automated analysis results to the manual assessment of atherosclerotic plaques. An overall pixel-wise accuracy of 81.5% with a classification feasibility of 76.5% and per-class accuracy of 89.5%, 72.1% and 79.5% for fibrotic, calcified and lipid-rich tissue respectively, was found. Moreover, measured optical properties were in agreement with previous results reported in literature. As such, an algorithm for automated tissue characterization was developed and validated using in vivo human data, suggesting that it can be applied to clinical IVOCT data. This might be an important step towards the integration of IVOCT in cardiovascular research and routine clinical practice.

Highlights

  • Coronary atherosclerotic plaques are mainly divided into lipid-rich, calcified and fibrous types, with mixed forms appearing in many cases

  • We developed an algorithm for the automated atherosclerotic tissue characterization in vivo through Intravascular optical coherence tomography (IVOCT) images

  • This will possibly contribute to the understanding of coronary atherosclerotic disease, aid in the assessment of the effect of new drugs and therapies on plaques, and, more in general, to the use of IVOCT in interventional cardiology research and clinical practice

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Summary

Introduction

Coronary atherosclerotic plaques are mainly divided into lipid-rich, calcified and fibrous types, with mixed forms appearing in many cases. Calcified plaques (CP) predominantly occur in stable lesions while acute coronary syndromes are typically caused by the rupture of a so called ‘vulnerable’ plaque, the TCFA (thin-cap fibroatheroma), consisting of an accumulation of extracellular lipid with a thin overlying fibrous cap [1,2]. Specific types of coronary plaques have been shown to impact the outcome of percutaneous coronary intervention (PCI) procedures [3,4,5,6]. Detailed identification and characterization of atherosclerotic lesions in vivo and quantification of relative morphological, chemical and mechanical parameters contributes in advancing the general understanding of coronary atherosclerotic disease and facilitating the development of new therapies and interventions. Most of the current available in vivo imaging modalities, such as intravascular ultrasound (IVUS) and computed tomography (CT), are limited by a low spatial resolution (>100μm) [7,8]

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