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Macrophages and intravascular OCT bright spots: a quantitative study
Jennifer E Phipps1, Deborah Vela2, Taylor Hoyt1
1University of Texas Health Science Center San Antonio, San Antonio, Texas.
JACC. Cardiovascular Imaging
|December 16, 2014
Summary
Bright spots in intravascular optical coherence tomography (IVOCT) are not solely from macrophages. Our algorithm reveals these bright spots are caused by various plaque components with differing refractive indexes, improving vulnerable plaque identification.
Area of Science:
- Cardiovascular imaging
- Biomedical optics
- Pathology
Background:
- Bright spots in intravascular optical coherence tomography (IVOCT) are traditionally attributed to macrophages.
- Previous research has not explored alternative explanations for these bright spots.
Purpose of the Study:
- To investigate the origins of bright spots in IVOCT images beyond macrophages.
- To develop and validate a quantitative algorithm for identifying bright spots based on optical properties.
Main Methods:
- IVOCT imaging of 14 human coronary arteries.
- Development of a quantitative algorithm considering tissue depth, light source distance, and signal-to-noise ratio.
- Histological analysis of co-registered tissue sections for comparison.
Main Results:
- Macrophages accounted for only 23% of bright spot origins, though present in 57% of positive regions.
- Other causes included fibrous tissue, calcium-lipid interfaces, and fibrous cap-lipid pools.
- Large macrophage pools with similar refractive indexes to lipids appeared as dark regions in IVOCT.
Conclusions:
- Bright spots in IVOCT images result from diverse plaque components causing refractive index variations.
- Improved algorithms incorporating these findings can enhance vulnerable plaque detection and standardize IVOCT interpretation.
