Ultrafast optical-ultrasonic system and miniaturized catheter for imaging and characterizing atherosclerotic plaques in vivo

Abstract

Atherosclerotic coronary artery disease (CAD) is the number one cause of death worldwide. The majority of CAD-induced deaths are due to the rupture of vulnerable plaques. Accurate assessment of plaques is crucial to optimize treatment and prevent death in patients with CAD. Current diagnostic techniques are often limited by either spatial resolution or penetration depth. Several studies have proved that the combined use of optical and ultrasonic imaging techniques increase diagnostic accuracy of vulnerable plaques. Here, we introduce an ultrafast optical-ultrasonic dual-modality imaging system and flexible miniaturized catheter, which enables the translation of this technology into clinical practice. This system can perform simultaneous optical coherence tomography (OCT)-intravascular ultrasound (IVUS) imaging at 72 frames per second safely in vivo, i.e., visualizing a 72 mm-long artery in 4 seconds. Results obtained in atherosclerotic rabbits in vivo and human coronary artery segments show that this ultrafast technique can rapidly provide volumetric mapping of plaques and clearly identify vulnerable plaques. By providing ultrafast imaging of arteries with high resolution and deep penetration depth simultaneously, this hybrid IVUS-OCT technology opens new and safe opportunities to evaluate in real-time the risk posed by plaques, detect vulnerable plaques, and optimize treatment decisions.

Ex vivo High-resolution Optical Coherence Tomography (OCT) Imaging of Pleural Reaction after Pleurodesis Using Talc

“…7). In study of fusion image using intra-vascular ultrasound (IVUS) and OCT image for detecting atherosclerosis, multimodal fusion imaging showed a complimentary role from the view of localization of lesion with IVUS and specification of lesion with OCT [24,25]. Therefore, OCT might have a potential complementary role in the early detection of pleural lesions when used in combination with other diagnostic approaches such as endoscopic ultrasound.…”

Influence of microvascular dysfunction on regional myocardial deformation post-acute myocardial infarction: insights from a novel angiographic index for assessing myocardial tissue-level reperfusion

“…Despite improvement in reperfusion strategies, patients who experience MVD following STEMI are known to exhibit a higher prevalence of early post-infarction complications, adverse left ventricular remodeling, recurrent hospitalizations, heart failure and mortality [3][4][5]20]. In the present study, restoration of myocardial perfusion was assessed angiographically by TMPFC, which measures the filling and clearance of contrast in the myocardium using cine-angiographic frame-counting to quantify myocardial tissue-level perfusion.…”

Arterial wall perfusion measured with photon counting spectral x-ray CT

“…Although there are several imaging methods used to detect and quantify atherosclerotic plaques, 16,17,18 CT as a method for quantifying vasa vasorum density is minimally invasive. The goal of our work is to develop a technique that detects pre-symptomatic atherosclerosis, i.e., before there is an acute arterial lumen occlusion or narrowing of the lumen by the large plaque.…”