Assessment of Coronary Atherosclerosis Progression and Regression at Bifurcations Using Combined IVUS and OCT

Diletti, Roberto; García‐García, Héctor M.; Gomez‐Lara, Josep; Brugaletta, Salvatore; Wykrzykowska, Joanna J.; Ditzhuijzen, Nienke van; Geuns, Robert Jan van; Regar, Evelyn; Ambrosio, Giuseppe; Serruys, Patrick W.

doi:10.1016/j.jcmg.2011.04.007

Cited by 40 publications

(20 citation statements)

References 12 publications

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“…The main reason for the IVOCT Volume 32, Number 1, p. 35-43, 2016 image acquisition is to analyze atherosclerotic plaques present in the vessel wall. Several studies (Diletti et al, 2011;Gonzalo et al, 2009;Ingebrigtsen et al, 2004) analyze the correlation between bifurcations and lesion formation. While Zarins et al (1983) suggests that flow separation has been proposed as hemodynamic potentiator of lesion formation, providing a motive for lumen segmentation in these regions.…”

Section: Introductionmentioning

confidence: 99%

A robust fully automatic lumen segmentation method for in vivo intracoronary optical coherence tomography

et al. 2016

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Introduction: Intravascular optical coherence tomography (IVOCT) is an in-vivo imaging modality based on the introduction of a catheter in a blood vessel for viewing its inner wall using electromagnetic radiation. One of the most developed automatic applications for this modality is the lumen area segmentation, however on the evaluation of these methods, the slices inside bifurcation regions, or with the presence of complex atherosclerotic plaques and dissections are usually discarded. This paper describes a fully-automatic method for computing the lumen area in IVOCT images where the set of slices includes complex atherosclerotic plaques and dissections. Methods: The proposed lumen segmentation method is divided into two steps: preprocessing, including the removal of artifacts and the second step comprises a lumen detection using morphological operations. In addition, it is proposed an approach to delimit the lumen area for slices inside bifurcation region, considering only the main branch. Results: Evaluation of the automatic lumen segmentation used manual segmentations as a reference, it was performed on 1328 human IVOCT images, presenting a mean difference in lumen area and Dice metrics of 0.19 mm 2 and 97% for slices outside the bifurcation, 1.2 mm 2 and 88% in the regions with bifurcation without automatic contour correction and 0.52 mm 2 and 90% inside bifurcation region with automatic contour correction. Conclusion: This present study shows a robust lumen segmentation method for vessel cross-sections with dissections and complex plaque and bifurcation avoiding the exclusion of such regions from the dataset analysis.

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Section: Introductionmentioning

confidence: 99%

A robust fully automatic lumen segmentation method for in vivo intracoronary optical coherence tomography

et al. 2016

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“…In addition, only three lesions with a stable phenotype at baseline evolved to TCFAs at follow-up. These findings were supported by the analysis of Diletti et al, 14 who used combined RF-IVUS and optical coherence tomographic (OCT) imaging to characterise plaque morphology in coronary bifurcations and assess for changes in the phenotype of the atheroma at 6 months follow-up and showed that most of the lipid-rich plaques (24 out of the 27 FAs and TCFAs) did not change their morphology at follow-up.…”

Section: Insights and Challenges Of Intracoronary Plaque Imagingmentioning

confidence: 62%

Vulnerable plaque detection: an unrealistic quest or a feasible objective with a clinical value?

Bourantas

García‐García

Torii

et al. 2016

Heart

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Evidence from the first prospective studies of coronary atherosclerosis demonstrated that intravascular imaging has limited accuracy in detecting lesions that are likely to progress and cause future events, and divided the scientific community into experts who advocate abandoning this quest and others who suggest intensifying our efforts improve and optimise the available imaging techniques. Although the current evidence may not justify the use of invasive or non-invasive imaging in the clinical setting for the detection of vulnerable, high-risk lesions, it is apparent that imaging has provided unique insights about plaque pathophysiology and evolution. Recent evidence indicates that both invasive and non-invasive imaging also provides useful prognostic information in patients with established coronary artery disease and in asymptomatic individuals and is likely to enable more accurate risk stratification. Future studies are anticipated to provide further insights about the value of novel hybrid imaging techniques, which are expected to enable complete assessment of plaque pathophysiology, in detecting vulnerable lesions and identifying high-risk patients that would benefit from new aggressive treatments targeting coronary atherosclerosis.

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“…Since then, several other researchers have used combined intravascular imaging to study coronary atheroma and changed our understanding about plaque evolution. Diletti et al used serial combined IVUS-VH-OCT imaging to study plaque characteristics in bifurcation lesions and found no difference in the fibrous cap thickness and necrotic core component at 6 months followup concluding that plaque evolution is a slow process and contradicted the findings of a previous report that used serial stand-alone IVUS to assess changes in plaque morphology at 1-year follow-up [25,66]. In another report, combined IVUS-OCT imaging was used to assess plaques that ruptured and caused events, plaques that had a silent rupture and nonruptured TCFAs.…”

Section: Multimodality Imagingmentioning

confidence: 95%

Invasive or non-invasive imaging for detecting high-risk coronary lesions?

Patel

Tarkin

Serruys

et al. 2017

Expert Review of Cardiovascular Therapy

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Introduction: Advances in our understanding about atherosclerotic evolution have enabled us to identify specific plaque characteristics that are associated with coronary plaque vulnerability and cardiovascular events. With constant improvements in signal and image processing an arsenal of invasive and non-invasive imaging modalities have been developed that are capable of identifying these features allowing in vivo assessment of plaque vulnerability. Areas covered: This review article presents the available and emerging imaging modalities introduced to assess plaque morphology and biology, describes the evidence from the first large scale studies that evaluated the efficacy of invasive and non-invasive imaging in detecting lesions that are likely to progress and cause cardiovascular events and discusses the potential implications of the in vivo assessment of coronary artery pathology in the clinical setting. Expert commentary: Invasive imaging, with its high resolution, and in particular hybrid intravascular imaging appears as the ideal approach to study the mechanisms regulating atherosclerotic disease progression; whereas non-invasive imaging is expected to enable complete assessment of coronary tree pathology, detection of high-risk lesions, more accurate risk stratification and thus to allow a personalized treatment of vulnerable patients. ARTICLE HISTORY

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Assessment of Coronary Atherosclerosis Progression and Regression at Bifurcations Using Combined IVUS and OCT

Cited by 40 publications

References 12 publications

A robust fully automatic lumen segmentation method for in vivo intracoronary optical coherence tomography

A robust fully automatic lumen segmentation method for in vivo intracoronary optical coherence tomography

Vulnerable plaque detection: an unrealistic quest or a feasible objective with a clinical value?

Invasive or non-invasive imaging for detecting high-risk coronary lesions?

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