Abstract

Evidence suggests high-resolution, high-contrast, [Formula: see text] intravascular optical coherence tomography (IVOCT) can distinguish plaque types, but further validation is needed, especially for automated plaque characterization. We developed experimental and three-dimensional (3-D) registration methods to provide validation of IVOCT pullback volumes using microscopic, color, and fluorescent cryo-image volumes with optional registered cryo-histology. A specialized registration method matched IVOCT pullback images acquired in the catheter reference frame to a true 3-D cryo-image volume. Briefly, an 11-parameter registration model including a polynomial virtual catheter was initialized within the cryo-image volume, and perpendicular images were extracted, mimicking IVOCT image acquisition. Virtual catheter parameters were optimized to maximize cryo and IVOCT lumen overlap. Multiple assessments suggested that the registration error was better than the [Formula: see text] spacing between IVOCT image frames. Tests on a digital synthetic phantom gave a registration error of only [Formula: see text] (signed distance). Visual assessment of randomly presented nearby frames suggested registration accuracy within 1 IVOCT frame interval ([Formula: see text]). This would eliminate potential misinterpretations confronted by the typical histological approaches to validation, with estimated 1-mm errors. The method can be used to create annotated datasets and automated plaque classification methods and can be extended to other intravascular imaging modalities.

Highlights

  • Intravascular optical coherence tomography (IVOCT) has demonstrated great promise in identifying key plaque features due to its resolution (10 to 20 μm), noise, and contrast among rival intravascular imaging modalities.[1,2,3,4,5]

  • IVOCT has been used to differentiate lipid, calcium, and fibrous tissue[1,2] and can quantify macrophage content within atherosclerotic plaques.[6]. It is the only modality with the ability to quantify fibrous cap thickness: a powerful indicator of the likelihood of thin cap fibroatheroma (TCFA) rupture,[7,8,9] which is believed to be the most frequent cause of myocardial infarction.[10,11,12,13]

  • Plaque Types Cryo-imaging allows easy identification of common plaque types confronted in IVOCT imaging

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Summary

Introduction

Intravascular optical coherence tomography (IVOCT) has demonstrated great promise in identifying key plaque features due to its resolution (10 to 20 μm), noise, and contrast among rival intravascular imaging modalities (intravascular ultrasound, near infrared spectroscopy, and intravascular MRI).[1,2,3,4,5] IVOCT has been used to differentiate lipid, calcium, and fibrous tissue[1,2] and can quantify macrophage content within atherosclerotic plaques.[6] it is the only modality with the ability to quantify fibrous cap thickness: a powerful indicator of the likelihood of thin cap fibroatheroma (TCFA) rupture,[7,8,9] which is believed to be the most frequent cause of myocardial infarction.[10,11,12,13]. It is sometimes difficult to distinguish between lipid pools and large calcium deposits.[3,14,15,16] superficial attenuation due to the presence of macrophages near the vessel intima, and signal attenuation resulting from oblique incidence of the IVOCT imaging beam, may lead to

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