Abstract. We developed robust, three-dimensional methods, as opposed to traditional A-line analysis, for estimating the optical properties of calcified, fibrotic, and lipid atherosclerotic plaques from in vivo coronary artery intravascular optical coherence tomography clinical pullbacks. We estimated attenuation μ t and backscattered intensity I 0 from small volumes of interest annotated by experts in 35 pullbacks. Some results were as follows: noise reduction filtering was desirable, parallel line (PL) methods outperformed individual line methods, root mean square error was the best goodness-of-fit, and α-trimmed PL (α-T-PL) was the best overall method. Estimates of μ t were calcified (3.84 AE 0.95 mm −1 ), fibrotic (2.15 AE 1.08 mm −1 ), and lipid (9.99 AE 2.37 mm −1 ), similar to those in the literature, and tissue classification from optical properties alone was promising. © The Authors. Published by SPIE under a Creative Commons Attribution 3.0 Unported License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.
The presence of extensive calcification is a primary concern when planning and implementing a vascular percutaneous intervention such as stenting. If the balloon does not expand, the interventionalist must blindly apply high balloon pressure, use an atherectomy device, or abort the procedure. As part of a project to determine the ability of Intravascular Optical Coherence Tomography (IVOCT) to aid intervention planning, we developed a method for automatic classification of calcium in coronary IVOCT images. We developed an approach where plaque texture is modeled by the joint probability distribution of a bank of filter responses where the filter bank was chosen to reflect the qualitative characteristics of the calcium. This distribution is represented by the frequency histogram of filter response cluster centers. The trained algorithm was evaluated on independent ex-vivo image data accurately labeled using registered 3D microscopic cryo-image data which was used as ground truth. In this study, regions for extraction of sub-images (SI’s) were selected by experts to include calcium, fibrous, or lipid tissues. We manually optimized algorithm parameters such as choice of filter bank, size of the dictionary, etc. Splitting samples into training and testing data, we achieved 5-fold cross validation calcium classification with F1 score of 93.7±2.7% with recall of ≥89% and a precision of ≥97% in this scenario with admittedly selective data. The automated algorithm performed in close-to-real-time (2.6 seconds per frame) suggesting possible on-line use. This promising preliminary study indicates that computational IVOCT might automatically identify calcium in IVOCT coronary artery images.
In this paper we present a new process for assessing optical properties of tissues from 3D pullbacks, the standard clinical acquisition method for iOCT data. Our method analyzes a volume of interest (VOI) consisting of about 100 A-lines spread across the angle of rotation (θ) and along the artery, z. The new 3D method uses catheter correction, baseline removal, speckle noise reduction, alignment of A-line sequences, and robust estimation. We compare results to those from a more standard, “gold standard” stationary acquisition where many image frames are averaged to reduce noise. To do these studies in a controlled fashion, we use a realistic optical artery phantom containing of multiple “tissue types.” Precision and accuracy for 3D pullback analysis are reported. Our results indicate that when implementing the process on a stationary acquisition dataset, the uncertainty improves at each stage while the uncertainty is reduced. When comparing stationary acquisition dataset to pullback dataset, the values were as follows: calcium: 3.8±1.09mm−1 in stationary and 3.9±1.2 mm−1 in a pullback; lipid: 11.025±0.417 mm−1 in stationary and 11.27±0.25 mm−1 in pullback; fibrous: 6.08±1.337 mm−1 in stationary and 5.58±2.0 mm−1. These results indicates that the process presented in this paper introduce minimal bias and only a small change in uncertainty when comparing a stationary and pullback dataset, thus paves the way to a highly accurate clinical plaque type discrimination, enabling automatic classification.
An estimated 17.5 million people died from a cardiovascular disease in 2012, representing 31 percent of all global deaths. Most acute coronary events result from rupture of the protective fibrous cap overlying an atherosclerotic plaque. The task of early identification of plaque types that can potentially rupture is, therefore, of great importance. The state-of-the-art approach to imaging blood vessels is intravascular optical coherence tomography (IVOCT). However, currently, this is an offline approach where the images are first collected and then manually analyzed an image at a time to identify regions at risk of thrombosis. This process is extremely laborious, time consuming and prone to human error. We are building a system that, when complete, will provide interactive 3D visualization of a blood vessel as an IVOCT is in progress. The visualization will highlight different plaque types and enable quick identification of regions at risk for thrombosis. In this paper, we describe our approach, focusing on machine learning methods that are a key enabling technology. Our empirical results using real OCT data show that our approach can identify different plaque types efficiently with high accuracy across multiple patients.
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