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Related Experiment Video

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Thinned-skull Cortical Window Technique for In Vivo Optical Coherence Tomography Imaging
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Fibrous Cap Thickness by Optical Coherence Tomography In Vivo.

Annapoorna S Kini1, Yuliya Vengrenyuk1, Takahiro Yoshimura1

  • 1Division of Cardiology, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai, New York, New York.

Journal of the American College of Cardiology
|December 20, 2016
PubMed
Summary
This summary is machine-generated.

Developing standardized interpretation criteria significantly improved the reproducibility of fibrous cap thickness (FCT) measurements using optical coherence tomography (OCT) imaging in vivo. This advancement enhances the reliability of OCT for assessing vulnerable plaques.

Keywords:
atherosclerosisinterobserver variabilityoptical coherence tomographythin-cap fibroatheroma

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Area of Science:

  • Cardiovascular Imaging
  • Medical Device Technology
  • Biomedical Engineering

Background:

  • Optical coherence tomography (OCT) offers high resolution for in vivo fibrous cap thickness (FCT) measurement.
  • Current OCT imaging exhibits unsatisfactory reproducibility for in vivo FCT measurements.

Purpose of the Study:

  • To determine if satisfactory reproducibility of in vivo FCT measurements using OCT can be achieved between independent observers.
  • To investigate methods for improving interobserver agreement in OCT-derived FCT measurements.

Main Methods:

  • Two independent observers analyzed 170 OCT pullbacks for FCT measurement reproducibility using intraclass correlation coefficient (ICC).
  • Sources of variability were identified and used to develop standardized lesion assessment criteria.
  • Reanalysis with developed criteria and assessment by a third observer evaluated improved reproducibility.
  • Maximal lipid arc assessment was also performed before and after criteria development.

Main Results:

  • Initial interobserver ICC for FCT was 0.56, indicating poor agreement.
  • High variability was attributed to poor definition of the fibrous cap border and neointimal macrophages/calcification.
  • After developing criteria, FCT measurement ICC improved to 0.88.
  • ICC for maximal lipid arc improved from 0.76 to 0.82.
  • A third observer achieved ICCs of 0.82 and 0.90 with the initial observers after coaching.

Conclusions:

  • Standardized interpretation algorithms and careful consideration of OCT features/artifacts significantly enhance interobserver agreement for FCT measurements.
  • Development of interpretation criteria can partially resolve interobserver variation in OCT-derived FCT assessment.
  • Improved reproducibility supports the clinical utility of OCT for vulnerable plaque characterization.