An assessment of the quality of optical coherence tomography image acquisition

Abstract

Optical coherence tomography (OCT) provides excellent image resolution, however OCT optimal acquisition is essential but could be challenging owing to several factors. We sought to assess the quality of OCT pullbacks and identify the causes of suboptimal image acquisition. We evaluated 784 (404 pre-PCI; 380 post-PCI) coronary pullbacks from an anonymized OCT database from our Cardiovascular Imaging Core Laboratory. Imaging of the region-of-interest (ROI-lesion or stented segment plus references) was incomplete in 16.1% pullbacks, caused by pullback starting too proximal (63.7%), inappropriate pullback length (17.1%) and pullback starting too distal (11.4%). The quality of image acquisition was excellent in 36.3% pullbacks; whereas 4% pullbacks were unanalyzable. Pullback quality was most commonly affected by poor blood displacement from inadequate contrast volume (27.4%) or flow (25.6%), followed by artifacts (24.1%). Acquisition mode was 'High-Resolution' (54 mm) in 74.4% and 'Survey' (75 mm) in 25.6% of cases. The 54 mm mode was associated with incomplete ROI imaging (p = 0.020) and inadequate contrast volume (p = 0.035). We observed a substantial frequency of suboptimal image acquisition and identified its causes, most of which can be addressed with minor modifications during the procedure, ultimately improving patient outcomes.

Efficacy of a new generation intracoronary optical coherence tomography imaging system with fast pullback

“…Although this novel HF-OCT system lays on the same fundamental | 525 than manual injections, also better controlling the amount of contrast medium injected during OCT imaging 25,26 ; therefore, it contributed to the low-contrast OCT image acquisition presented in this study. A 5 mL contrast medium injection is as small as the amount of contrast medium used to image a coronary angiogram.…”

“…With this study, we proved the feasibility of a low‐contrast, fast‐pullback, HF‐OCT imaging procedure for coronary lesion assessment using only 5 mL of contrast. The use of automated contrast injectors is known to provide better and more reproducible image quality than manual injections, also better controlling the amount of contrast medium injected during OCT imaging 25,26 ; therefore, it contributed to the low‐contrast OCT image acquisition presented in this study. A 5 mL contrast medium injection is as small as the amount of contrast medium used to image a coronary angiogram.…”

Volumetric microscopy of cerebral arteries with a miniaturized optical coherence tomography imaging probe

“…The clear length of the scans expressed in millimeters was measured in all 72 pullbacks acquired automatically (for which the scan acquisition speed is known) using established criteria, known as the CIL ( 49 ). CIL represents the length of the scan without blood shadowing artifacts.…”

Challenges and Burdens in the Coronary Artery Disease Care Pathway for Patients Undergoing Percutaneous Coronary Intervention: A Contemporary Narrative Review

“…Similarly, IVUS and optical coherence tomography (OCT) for intravascular imaging PCI have also not been consistently adopted, partly due to a lack of training, the associated learning curve [156], costs, and a lack of adequate reimbursement. Expertise is required to guide PCI using IVUS, a process prone to bias and human error [157], while image acquisition using OCT can be suboptimal without proper education and training [158]. Implementing a standardized and streamlined image acquisition protocol and efficient training with complex technologies would help minimize errors in image interpretation, optimize procedural results, and improve patient outcomes.…”