Abstract
The rupture of thin-cap fibroatheroma accounts for most acute coronary events. Optical Coherence Tomography (OCT) allows quantification of fibrous cap (FC) thickness in vivo. Conventional manual analysis, by visually determining the thinnest part of the FC is subject to inter-observer variability and does not capture the 3-D morphology of the FC. We propose and validate a computer-aided method that allows volumetric analysis of FC. The radial FC boundary is semi-automatically segmented using a dynamic programming algorithm. The thickness at every point of the FC boundary, along with 3-D morphology of the FC, can be quantified. The method was validated against three experienced OCT image analysts in 14 lipid-rich lesions. The proposed method may advance our understanding of the mechanisms behind plaque rupture and improve disease management.
Highlights
Coronary artery disease (CAD) is the most frequent cause of death worldwide
An ex vivo morphometric assessment of 41 ruptured coronary plaques revealed that the mean cap thickness was 23 ± 19 μm and 95% of these fibrous cap (FC) measured less than 64 μm [5]
A fibrous cap (FC) with the minimum cap thickness
Summary
Coronary artery disease (CAD) is the most frequent cause of death worldwide. Each year, an estimate of 785,000 Americans will have a new coronary attack, and about 470,000 will have a recurrent event [1]. A thickness of 65μm has been considered the instability threshold, and thickness of the FC has been considered one of the major morphometric determinants of those plaques prone to rupture [3,4]. Identifying these so-called “vulnerable plaques” before symptoms arise, may allow the adoption of preventive therapeutic measures to avoid subsequent myocardial infarctions and sudden deaths. This largely relies on improvement of imaging technologies that allow better characterization of fibroatheroma in vivo
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