Comparison between different approaches to evaluate fibrous cap thickness in sequential optical coherence tomography...

Area of Science:

• Cardiovascular Imaging
• Medical Device Technology
• Interventional Cardiology

Background:

• Optical coherence tomography (OCT) is an intravascular imaging modality.
• Assessing lumen area (LA) and plaque components like lipid arc and fibrous cap thickness (FCt) is crucial for cardiovascular disease management.
• Reproducibility of OCT measurements is essential for reliable serial assessments.

Purpose of the Study:

• To evaluate the reproducibility of lumen area (LA) and plaque component measurements using OCT.
• To compare different methods for assessing fibrous cap thickness (FCt) reproducibility.
• To determine the reliability of OCT for quantitative plaque analysis in coronary arteries.

Main Methods:

• In-vivo human study involving two repeated OCT pullbacks from the same diseased coronary segments.
• Assessment of lumen area (LA), lipid arc, and fibrous cap thickness (FCt).
• Comparison of four distinct approaches for minimal FCt measurement, including longitudinal and segmental analyses.

Main Results:

• Suboptimal in-segment correlation for LA (ICC 0.731) but good correlation for lipid arc (ICC 0.963).
• High reproducibility for FCt measurement with continuous (longitudinal) assessment.
• Best reproducibility for FCt observed with Longitudinal-spot minimal FCt value and Longitudinal-plot mean FCt (ICC 0.893 and 0.952).

Conclusions:

• OCT demonstrates good reproducibility for quantitative plaque measurements, confirming its reliability for serial assessments.
• Longitudinal measurement in adjacent frames is the most accurate and reproducible method for sequential FCt assessment.
• OCT is a reliable tool for monitoring changes in coronary plaque components over time.