High-Definition Intravascular Ultrasound Versus Optical Coherence Tomography: Lumen Size and Plaque Morphology

Area of Science:

• Cardiovascular Imaging
• Interventional Cardiology

Background:

• Complex percutaneous coronary interventions utilize intravascular imaging like IVUS and OCT.
• Accurate lumen and plaque assessment is crucial for guiding these procedures.

Purpose of the Study:

• To compare the accuracy of the latest high-definition intravascular ultrasound (HD IVUS) and optical coherence tomography (OCT) in measuring coronary lumen dimensions and assessing plaque morphology.

Main Methods:

• Comparison of HD IVUS and OCT in 8 silicone models using microcomputed tomography as ground truth.
• Clinical comparison of HD IVUS and OCT in 12 coronary arteries from 9 patients.

Main Results:

• In models, HD IVUS overestimated MLD (+0.06 ± 0.05 mm), while OCT underestimated it (-0.17 ± 0.06 mm).
• In patients, HD IVUS yielded larger lumen dimensions than OCT (+0.12 ± 0.11 mm for latest HD IVUS).
• HD IVUS demonstrated precision in detecting fine wall structures like fibrous caps and stent struts when compared to OCT.

Conclusions:

• Latest HD IVUS (Avvigo+) tends to overestimate lumen size; OCT (Ultreon 2.0) underestimates it.
• Experimental data suggest HD IVUS offers more accurate lumen assessment, especially in larger coronary arteries.
• Both technologies show comparable overall accuracy in the clinical setting for coronary artery assessment.