Comprehensive Assessment of High-Risk Plaques by Dual-Modal Imaging Catheter in Coronary Artery

Area of Science:

• Cardiovascular Imaging
• Biomedical Optics
• Artificial Intelligence in Medicine

Background:

• Coronary plaque destabilization is a complex process involving microstructural and biochemical changes.
• Current imaging modalities lack the comprehensive characterization needed for high-risk plaque assessment.
• Accurate identification of plaque components is crucial for predicting and preventing cardiovascular events.

Purpose of the Study:

• To develop and validate a novel imaging approach for simultaneous microstructural and biochemical characterization of coronary plaques.
• To assess the feasibility of using integrated optical coherence tomography and fluorescence lifetime imaging (FLIm) in a beating heart.
• To enable automated, quantitative imaging of key plaque components indicative of destabilization.

Main Methods:

• Integration of optical coherence tomography (OCT) with multispectral fluorescence lifetime imaging (FLIm).
• Utilizing unique fluorescence lifetime signatures of plaque components like lipids, macrophages, and fibrotic tissues.
• Incorporation of a machine learning framework to process FLIm data and enable automated analysis.

Main Results:

• Demonstrated simultaneous microstructural and biochemical assessment of coronary plaques in vivo.
• Identified distinct fluorescence lifetime signatures for lipids, macrophages, and fibrotic tissues.
• Achieved automated, quantitative imaging of multiple plaque components relevant to destabilization using machine learning-enhanced FLIm.

Conclusions:

• The integrated OCT-FLIm system provides a comprehensive characterization of coronary plaque composition and microstructure.
• Multispectral FLIm, coupled with machine learning, offers a powerful tool for identifying vulnerable plaques.
• This advanced imaging approach has the potential to improve risk stratification and guide therapeutic interventions for coronary artery disease.