Three-dimensional coronary reconstruction and endothelial shear stress assessment using frequency domain optical coherence tomography & angiography in humans: comparison with intravascular ultrasound

Abstract

Purpose: Realistic 3-dimensional (3D) coronary artery reconstruction is essential to determine local endothelial shear stress (ESS) patterns responsible for atherosclerosis evolution. Intravascular ultrasound (IVUS) has been the mainstay of such studies. Recently introduced Frequency Domain Optical Coherence Tomography (FD-OCT) provides additional high-resolution information. We aimed to develop a method that permits accurate 3D reconstruction from FD-OCT & angiographic data enabling reliable evaluation of the ESS distribution, and to compare the FD-OCT–derived models against the established 3D models based on angiography/IVUS. Methods: Fifteen patients (17 coronary arteries) investigated with angiography, FD-OCT and IVUS during the same procedure were studied. The FD-OCT and IVUS lumen borders were placed onto the 3D luminal centerline derived from angiographic data. 3D geometry algorithms & anatomical landmarks were used to appropriately orientate the borders. ESS was calculated using computational fluid dynamics (Figure). Results: In 188 corresponding consecutive 3-mm segments, lumen area was highly correlated in the models derived from the two imaging modalities (r=0.96), as was local ESS (r=0.89). FD-OCT–based 3D reconstructions had a high diagnostic accuracy for detecting regions exposed to the atherogenic low ESS identified on the IVUS-based 3D models, considered as the gold standard (receiver-operator characteristic area under the curve: 94.9%). ![Figure][1] ESS in 3D model (A) & Cross-section (B) Conclusions: FD-OCT–based 3D reconstruction provides anatomically-correct models and permits reliable ESS computation. ESS assessment combined with the superior definition of plaque characteristics by FD-OCT is expected to provide valuable insight into the effect of the hemodynamic milieu on the development/destabilization of high-risk plaques. [1]: pending:yes