Fully Automated Lipid Pool Detection Using Near Infrared Spectroscopy

Background. Detecting and identifying vulnerable plaque, which is prone to rupture, is still a challenge for cardiologist. Such lipid core-containing plaque is still not identifiable by everyday angiography, thus triggering the need to develop a new tool where NIRS-IVUS can visualize plaque characterization in terms of its chemical and morphologic characteristic. The new tool can lead to the development of new methods of interpreting the newly obtained data. In this study, the algorithm to fully automated lipid pool detection on NIRS images is proposed. Method. Designed algorithm is divided into four stages: preprocessing (image enhancement), segmentation of artifacts, detection of lipid areas, and calculation of Lipid Core Burden Index. Results. A total of 31 NIRS chemograms were analyzed by two methods. The metrics, total LCBI, maximal LCBI in 4 mm blocks, and maximal LCBI in 2 mm blocks, were calculated to compare presented algorithm with commercial available system. Both intraclass correlation (ICC) and Bland-Altman plots showed good agreement and correlation between used methods. Conclusions. Proposed algorithm is fully automated lipid pool detection on near infrared spectroscopy images. It is a tool developed for offline data analysis, which could be easily augmented for newer functions and projects

Reproducibility of optical coherence tomography in vein grafts used for coronary revascularization

Background: Optical coherence tomography (OCT) is a high-resolution imaging modality able to provide near-histological images of vessel walls making it possible to distinguish intima and media layers of the vessel wall separately. The use of this imaging technique is increasing while data on the variability and reliability is lacking. The aim of this study was to investigate the reproducibility of frequency-domain OCT in vein grafts used for coronary revascularization.Methods: Five pullbacks were analyzed by the same analyst with a 1-month delay (intraobserver) and by two different analysts (interobserver). Five pairs of pullbacks from the same catheters and vein graft were also analyzed (inter pullback).Results: Optical coherence tomography showed low variability in intra- and interobserver analysis with relative differences of mean media and intima thicknesses and areas of less than 5% for most parameters.Relative differences of the same parameters in the inter pullback analysis were in the 5–15% range. Intra- and interobserver reliability was excellent (intraclass correlation coefficient [ICC] > 0.90) for intima thickness and intima, media and intima-media area measurements. Inter pullback reliability was good (ICC: 0.75–0.90) for intima and intima-media area measurements, and moderate to good for mean intima thickness measurements (ICC: 0.79; 0.7338–0.8284).Conclusions: Optical coherence tomography provides good reproducibility for the measurements of parameters relevant for the development of atherosclerosis in vein grafts.Clinical trial registration: ID NCT01834846

The influence of high-density lipoprotein cholesterol on maximal lipid core burden indexing thin cap fibrous atheroma lesions as assessed by near infrared spectroscopy

Background: Previous studies suggest that higher plasma concentrations of several lipid molecules are associated with higher lipid core burden index (LCBI) NIRS imaging. The aim of this study was to investigate whether an association between plasma lipids depends on plaque morphology (thin cap fibrous atheroma [TCFA] vs. non-TFCA) as measured by near-infrared spectroscopy–intravascular ultrasound (NIRS-IVUS). Methods: 64 patients retrospectively enrolled were diagnosed with stable coronary artery disease or acute coronary syndrome who underwent NIRS-IVUS imaging. Before percutaneous coronary intervention, blood samples were collected for measurement of serum levels of total cholesterol (TC), low-density lipoprotein cholesterol (HDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides. Patients were divided into two groups based on maxLCBI4mm and IVUS imaging. Those with maxLCBI4mm ≥ 323 were included into TCFA group (n = 35) while others were assigned to the non-TCFA group (n = 29). Results: Thin cap fibrous atheroma (TCFA) lesions were significantly longer than the non-TCFA lesions (25.66 ± 9.56 vs. 17.03 ± 9.22, p = 0.001). TCFA characterizes greater plaque burden (78.4 [70.9, 82.2] vs. 72.70 [64.77, 76,05]; p = 0.021) and plaque volume (176.1 [110.75, 247.5] vs. 68.1 [55.58, 143.35]; p = 0.000) as compared to non-TCFA. In TCFA suspected lesions, there was no correlation between maxLCBI4mm and LDL levels (r = 0.105, p = 0.549) nor TC levels (r = –0.035, p = 0.844) but a negative correlation was found between HDL-C and maxLCBI4mm (r = –0.453, p = 0.007). Conclusions: The present study showed that there was no correlation between plasma LDL-C, TCH and TG level and the amount of lipids in coronary plaque assessed by NIRS in both TCFA and non-TCFA groups. Only HDL-C correlated with maxLCBI4mm in TCFA lesions

Prediction models for different plaque morphology in non-significantly stenosed regions of saphenous vein grafts assessed with optical coherence tomography

Introduction: Coronary artery bypass grafting (CABG) is a method of choice in treatment of diffuse coronary artery disease (CAD), although it has some limitations such as late saphenous vein graft (SVG) patency loss, which occurs in one fifth of all conduits at 5 years. Since atherosclerosis in SVG has diffuse characteristics, it appears that significantly and non-significantly stenosed lesions may have an equal impact on worse prognosis. Aim: To assess non-significant lesions of SVG by the use of optical coherence tomography (OCT) and investigate the clinical and laboratory findings with the potential impact on plaque composition. Material and methods: Twenty-nine patients with 43 non-significant lesions were enrolled in the study. All variables were assessed using uni- and multivariable logistic regression analysis with each plaque morphology as a dependent variable. Odds ratio (OR) and 95% confidence interval (CI) were computed. Results: Plaque rupture (PRT) was independently associated with age (OR = 1.49, 95% CI: 1.09–2.04, p = 0.015) and lower rates of high-density lipoproteins (HDL) cholesterol (OR = 0.67, 95% CI: 0.49–0.92, p = 0.016). Intimal tearing or rupture (ITR) was related to reduced GFR (OR = 0.52, 95% CI: 0.38–0.72, p = 0.0004). Lipid-rich plaque (LRP) was associated with raised platelet count (PLT) (OR = 1.51, 95% CI: 1.16–1.96, p = 0.004) and increased frequency of smoking (OR = 1.45, 95% CI: 1.12–1.89, p = 0.007). Conclusions: Atherosclerosis of SVG is not restricted to significantly stenosed lesions. Plaque composition is independently associated with different types of clinical and laboratory findings, mostly recognized as risk factors of CAD

Fully Automated Lumen Segmentation Method for Intracoronary Optical Coherence Tomography.

BACKGROUND: Optical coherence tomography (OCT) is an innovative imaging technique that generates high-resolution intracoronary images. In the last few years, the need for more precise analysis regarding coronary artery disease to achieve optimal treatment has made intravascular imaging an area of primary importance in interventional cardiology. One of the main challenges in OCT image analysis is the accurate detection of lumen which is significant for the further prognosis. METHOD: In this research, we present a new approach to the segmentation of lumen in OCT images. The proposed work is focused on designing an efficient automatic algorithm containing the following steps: preprocessing (artifacts removal: speckle noise, circular rings, and guide wire), conversion between polar and Cartesian coordinates, and segmentation algorithm. RESULTS: The implemented method was tasted on 667 OCT frames. The lumen border was extracted with a high correlation compared to the ground truth: 0.97 ICC (0.97-0.98). CONCLUSIONS: Proposed algorithm allows for fully automated lumen segmentation on optical coherence tomography images. This tool may be applied to automated quantitative lumen analysis.Peer Reviewe