This document summarizes research on using optical coherence tomography (OCT) to characterize coronary plaques. OCT uses near-infrared light to generate high-resolution cross-sectional images of tissue microstructure. Researchers studied 357 arterial segments ex vivo using OCT and validated plaque types (fibrous, calcific, lipid-rich) against histology with high accuracy. A pilot clinical study of 10 patients found OCT feasible and safe for in vivo coronary imaging before and after percutaneous coronary intervention, identifying a variety of plaque types and stent appositions. While blood obstruction and motion artifacts posed challenges, the results support further evaluation of OCT as a potential "optical biopsy" tool.
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1. Optical Coherence
Tomography: Optical Biopsy
with a Short Photonic
Needle?
I.K. Jang, MD
Massachusetts General Hospital
Harvard Medical School
The 3rd
Vulnerable Plaque Symposium
Atlanta, March 16, 2002
2. Optical Coherence
Tomography
โข Optical analog of ultrasound
โข Cross-sectional imaging
โข 10 ยตm resolution
โข 2 mm penetration depth
Low signal High signal
3. MGH OCT
System Technical
Data
Optical wavelength :
Image acquisition rate :
Catheter:
Axial Resolution :
Transverse Resolution :
Data storage :
1300 nm
4-8 images / sec
3.0 F
10 ยตm
25 ยตm
Digital
4. Ex Vivo Study
Aim
Establish OCT criteria for plaque
characterization
Materials and Methods
โข 357 arterial segments from 90 cadavers
โ 78 Coronary; 86 Carotid; 143 Aorta
โข training set, n=50
validation set, n = 307
โข Specimen registration
โข OCT imaging
โข Histology processing
โข Correlation of OCT with histology
5. Ex Vivo Study
Type Number
Fibrous 11 (22%)
Calcific 27 (54%)
Lipid pool 12 (24%)
Type Number
Fibrous 67 (22%)
Calcific 167 (54%)
Lipid pool 73 (24%)
Validation Set (n = 307)Training Set (n = 50)
Histologic Diagnoses
13. Pilot Human Study
Aim: Test feasibility and safety of OCT in
patients
Methods
โข 10 patients (average age 59, 8M/2F)
โข Coronary angiogrpahy
โข IVUS + OCT imaging (3.2 F catheter)
โข PCI
โข Repeat IVUS + OCT Imaging
25. Pilot Human Study Results
๏ง No OCT related complications
๏ง Variety of pathology imaged and
compared with IVUS
โข 10 patients with 28 plaque segments
โข 8 dissections
โข 13 stent locations
๏ง Problems
โข Obstruction by blood
โข Motion artifacts
26. Acknowledgements
Massachusetts General Hospital
Cardiology Division
H. Yabushita, B. MacNeill, H. Lowe, M. Hayashi, S. Clarke, E. Pomerantsev,
D. DeJoseph, I.K. Jang
Wellman Laboratories of Photomedicine
B.E. Bouma, M. Shishkov, C. Kauffman, N. Iftima, G.J. Tearney
Dept. of Pathology
S. Houser, H.T. Aretz
CIMIT
J. Muller, T. Brady, J. Rosen
Guidant Corporation
D. Kilpatrick, J. Ellis, R. Jones, T. Linnemeier
Editor's Notes
To date, there are two MGH prototype systems, with another under construction. All optics and electronics reside within a portable enclosure that can easily be transported to the clinical site. A photograph of one the the MGH OCT systems is shown in the upper right hand corner of this slide.
A videoendoscopy image, present in the lower right hand corner of this slide, shows the typical view of the OCT catheter protruding through the accessory port. Light emanates from the OCT catheter in a direction that is perpendicular to the axis of the endoscope. The beam scans along the side of the hollow organ in a linear fashion.