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Updated: Aug 19, 2025
Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
Published on: January 15, 2022
Potential of optical frequency domain imaging for differentiation between early and advanced coronary atherosclerosis
Takahiro Imanaka1,2, Kenichi Fujii3, Takamasa Tanaka1,2
1Department of Cardiovascular and Renal Medicine, Hyogo College of Medicine, Hyogo, Japan.
Insights
Optical frequency domain imaging (OFDI) can distinguish fibroatheroma (FA) from pathological intimal thickening (PIT) by analyzing lipid plaque dimensions. While signal attenuation was similar, OFDI effectively differentiates these conditions based on lipid extent and cap thickness.
Area of Science:
- Cardiovascular Imaging
- Histopathology
- Atherosclerosis Research
Background:
- Distinguishing between fibroatheroma (FA) and pathological intimal thickening (PIT) is crucial for understanding plaque progression.
- Optical frequency domain imaging (OFDI) is an advanced imaging technique with potential for in vivo plaque characterization.
Purpose of the Study:
- To evaluate the accuracy of OFDI in differentiating FA from PIT compared with histopathology.
- To assess specific OFDI parameters for distinguishing these two atherosclerotic lesion types.
Main Methods:
- Analysis of 631 histological cross-sections from 14 autopsy hearts.
- Comparison of OFDI images with corresponding histopathology for diagnosing PIT and FA.
- Measurement of OFDI signal attenuation rate, lipid length, lipid arc, and fibrous cap thickness.
Main Results:
- No significant difference in OFDI signal attenuation rate between FA and PIT (p=0.13).
- FA showed significantly longer lipid length (p<0.0001), larger lipid arc (p<0.0001), and thinner fibrous cap thickness (p=0.019) compared to PIT.
- Histopathology confirmed 190 cases of PIT and 120 cases of FA.
Conclusions:
- OFDI demonstrates potential for discriminating FA from PIT.
- Discrimination is based on the longitudinal and circumferential extent of lipid plaque, not signal attenuation rate.
- OFDI parameters like lipid length, arc, and cap thickness are key differentiators.
Purpose:
This study evaluated whether optical frequency domain imaging (OFDI) accurately distinguish between fibroatheroma (FA) and pathological intimal thickening (PIT) compared with histopathology.
Methods:
A total of 631 histological cross-sections from 14 autopsy hearts were analyzed for the comparison between OFDI and histological images. Of those, 190 (30%) sections were diagnosed with PIT and 120 (19%) with FA. The OFDI signal attenuation rate was calculated from an exponential. The lipid length was measured longitudinally by detection of sequential OFDI frames within a plaque segment containing lipids. The lipid arc was measured with a protractor centered in the center of the lumen. The fibrous cap thickness was defined as the minimum thickness of the signal rich band overlying PIT and FA.
Results:
There was no significant difference in the OFDI signal attenuation rate between FA and PIT (3.09 ± 1.04 versus 2.79 ± 1.20, p = 0.13). However, the lipid length was significantly longer, the maximum lipid arc was significantly larger, and the fibrous cap thickness was significantly thinner in FA than in PIT (7.5 [4.3-10.3] mm versus 4.3 [2.7-5.8] mm, p < 0.0001, 125 [101-174]° versus 96 [74-131]°, p < 0.0001, and 220 [167-280] µm versus 260 [190-332] µm, p = 0.019).
Conclusions:
This study revealed OFDI may have the potential capability for discriminating FA from PIT based on the longitudinal and circumferential extent of lipid plaque, although the OFDI signal attenuation rate was similar between FA and PIT.
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