059 can oct catheter see plaque macrophages
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Editorial Slides VP Watch January 15 2003 Volume 1 Issue 2
Can OCT Catheter See Plaque Macrophages
ndash Optical coherence tomography (OCT) is analogous to ultrasound measuring the intensity of back-reflected light (near infrared light) rather than sound (acoustical waves)
ndash An OCT image represents a cross sectional picture of the optical reflectance properties of tissue 4
ndash OCT originally developed to image the transparent tissue of the eye with unprecedented resolution
Brezinski Tearney Bouma Fujimoto and colleagues in 1997 discussed the advantages of OCT as following
bull High resolution bull Broad dynamic range and bull Ability to be delivered through
intravascular catheters 2
ndash In vitro studies have shown that the resolution of OCT (10-20 micron) can resolve the thin fibrous caps thought to be responsible for plaque vulnerability 1
ndash Catheter-based diagnostic techniques can provide structural information with higher resolution than non-invasive methods OCT achieves at least 10 times higher resolution than IVUS and can be adapted for catheter-based imaging of vulnerable plaque 3
IVUS OCT
Coronary IVUS vs Coronary OCT
Tearney Boma Chang et al
Tearney Jang and colleagues showed that in vivo OCT imaging of normal coronary arteries intimal dissections and deployed stents in swine is feasible and allows identification of clinically relevant coronary artery morphology with high-resolution and contrast 4
bull As highlighted in VP Watch of this week Tearney and colleagues showed OCT can characterize structure of atherosclerotic plaque ex-vivo5
bull They further showed that macrophage content of plaque cap can be identified by OCT 5
bull Ex vivo studiesndash Plaque characterizationndash Cap thicknessndash Macrophage density
bull In vivo studiesndash Feasibilityndash Post-MI
Fibrous
Calcific
LIPID
Yabushita Tearney et al Circulation 2002
Plaque Characterization Studybull Evaluate diagnostic potential (lipid pools)
bull Methodsndash 357 diseased arterial segments from 90 cadavers
bull 78 Coronary 86 Carotid 143 Aortandash OCT imaging histology processing registrationndash Correlation of OCT with histology
ndash Develop OCT criteria for characterization (training set n=50)ndash Prospectively test OCT criteria (validation set n = 307)ndash Two OCT readers and two pathologists
Yabushita Tearney et al Circulation 2002
Plaque Characterization
lp
lp
HomogeneousSignal-rich
Fibrous Lipid pool
Echolucent Diffuse Borders
Echolucent Sharp Borders
CalcificOCT Criteria training set (n=50)
500 microm
Plaque Characterization Results
SENS 79SPEC 97
SENS 95SPEC 97
SENS 90SPEC 92
bull Accuracy Statistics
bull Fibrous
bull Calcific
bull Lipid pool
Interobserver = 088 Intraobserver = 091 Yabushita Tearney et al Circulation 2002
bull Technology development
bull Ex vivo studiesndash Plaque characterizationndash Cap thicknessndash Macrophage density
bull In vivo studiesndash Feasibilityndash Post-MIndash Epidemiologyndash Prospective trials
M produce proteasesDegrade collagen and matrix
Impair structural integrity of cap
CD68 Immunoperoxidase
Cap
Lipid
Tearney Bouma et al Circulation 2003
Macrophage Studybull Can OCT quantify macrophage content
bull Methodsndash 26 diseased arterial segments from 17 cadavers
bull 7 Carotid 19 Aortandash OCT imagingndash Histology processing - CD68 SMA trichromendash Correlation of OCT with histologyndash 500x125 microm ROIndash Histology - automatic segmentation - area stainingndash OCT - quantitative image analysis
NSD
Smax Smin
Tearney Bouma et al Circulation 2003
Macrophage Study
250 microm
OCT
CD68
Low M High M
Tearney Bouma et al Circulation 2003
Linear NSD vs CD68
CD68 area gt 10 - NSD cutoff 62
R = 084P lt 00001
Tearney Bouma et al Circulation 2003
Human Coronary Artery In Vivo
P
G
L
F
G
2x
ma
i
iel eel
F
OCT IVUS
Tearney Bouma et al Circulation 2003
Calcified Plaques In Vivo
OCT IVUS
Tearney Bouma et al Circulation 2003
Lipid-rich Plaque In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Thrombus In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Conclusionbull Intracoronary OCT represents a new
technology for microscale imaging of atherosclerotic plaque
bull In exvivo studies OCT can identify macrophage intensity in plaque cap
bull Given above OCT can be an important addition to cardiovascular cat labs may completely replace IVUS catheter
Questions
I Presence of blood induces artifacts for OCT imaging knowing the time constraint in cath labs the question is how practically OCT catheter can be utilized for screening vulnerable plaques throughout total coronary arteries
Questionsbull Assuming the limited use of IVUS
(lt20) for plaque characterization in cath labs is due to cost issue would OCT with equal price be cost effective
bull With the trend towards non-invasive diagnosis and using invasive procedure only for therapy how will OCT be greeted by interventional cardiologists
ReferencesReferences
1- Fujimoto JG Boppart SA Tearney GJ Bouma BE Pitris C Brezinski ME High resolution in vivo intra-arterial imaging with optical coherence tomography Heart 1999 Aug82(2)128-33
2- Brezinski ME Tearney GJ Weissman NJ Boppart SA Bouma BE Hee MR Weyman AE Swanson EA Southern JF Fujimoto JG Assessing atherosclerotic plaque morphology comparison of optical coherence tomography and high frequency intravascular ultrasound Heart 1997 May77(5)397-403
3- Ik-Kyung Jang Brett E Bouma Dong-Heon Kang Seung-Jung Park Seong-Wook Park Ki-Bae Seung Kyu-Bo Choi Milen Shishkov Kelly Schlendorf Eugene Pomerantsev et al Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography comparison with intravascular ultrasound Pages 604-609 Journal of the American College of Cardiology 2002 Volume 39(4) 604-609
4- Tearney GJ Jang IK Kang DH Aretz HT Houser SL Brady TJ Schlendorf K Shishkov M BoumaBE Porcine coronary imaging in vivo by optical coherence tomography Acta Cardiol 2000 Aug55(4)233-7
5- Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography Tearney Guillermo Yabushita Hiroshi Houser Stuart Aretz H Jang Ik-kyung Schlendorf Kelly Kauffman Christopher Shishkov Milen Halpern Elkan Bouma Brett Circulation 2003107113
- Editorial Slides VP Watch January 15 2003 Volume 1 Issue 2
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Plaque Characterization Study
- Plaque Characterization
- Plaque Characterization Results
- Slide 12
- Macrophage Study
- Slide 14
- Linear NSD vs CD68
- Human Coronary Artery In Vivo
- Calcified Plaques In Vivo
- Lipid-rich Plaque In Vivo
- Thrombus In Vivo
- Conclusion
- Questions
- Slide 22
- Slide 23
-
ndash Optical coherence tomography (OCT) is analogous to ultrasound measuring the intensity of back-reflected light (near infrared light) rather than sound (acoustical waves)
ndash An OCT image represents a cross sectional picture of the optical reflectance properties of tissue 4
ndash OCT originally developed to image the transparent tissue of the eye with unprecedented resolution
Brezinski Tearney Bouma Fujimoto and colleagues in 1997 discussed the advantages of OCT as following
bull High resolution bull Broad dynamic range and bull Ability to be delivered through
intravascular catheters 2
ndash In vitro studies have shown that the resolution of OCT (10-20 micron) can resolve the thin fibrous caps thought to be responsible for plaque vulnerability 1
ndash Catheter-based diagnostic techniques can provide structural information with higher resolution than non-invasive methods OCT achieves at least 10 times higher resolution than IVUS and can be adapted for catheter-based imaging of vulnerable plaque 3
IVUS OCT
Coronary IVUS vs Coronary OCT
Tearney Boma Chang et al
Tearney Jang and colleagues showed that in vivo OCT imaging of normal coronary arteries intimal dissections and deployed stents in swine is feasible and allows identification of clinically relevant coronary artery morphology with high-resolution and contrast 4
bull As highlighted in VP Watch of this week Tearney and colleagues showed OCT can characterize structure of atherosclerotic plaque ex-vivo5
bull They further showed that macrophage content of plaque cap can be identified by OCT 5
bull Ex vivo studiesndash Plaque characterizationndash Cap thicknessndash Macrophage density
bull In vivo studiesndash Feasibilityndash Post-MI
Fibrous
Calcific
LIPID
Yabushita Tearney et al Circulation 2002
Plaque Characterization Studybull Evaluate diagnostic potential (lipid pools)
bull Methodsndash 357 diseased arterial segments from 90 cadavers
bull 78 Coronary 86 Carotid 143 Aortandash OCT imaging histology processing registrationndash Correlation of OCT with histology
ndash Develop OCT criteria for characterization (training set n=50)ndash Prospectively test OCT criteria (validation set n = 307)ndash Two OCT readers and two pathologists
Yabushita Tearney et al Circulation 2002
Plaque Characterization
lp
lp
HomogeneousSignal-rich
Fibrous Lipid pool
Echolucent Diffuse Borders
Echolucent Sharp Borders
CalcificOCT Criteria training set (n=50)
500 microm
Plaque Characterization Results
SENS 79SPEC 97
SENS 95SPEC 97
SENS 90SPEC 92
bull Accuracy Statistics
bull Fibrous
bull Calcific
bull Lipid pool
Interobserver = 088 Intraobserver = 091 Yabushita Tearney et al Circulation 2002
bull Technology development
bull Ex vivo studiesndash Plaque characterizationndash Cap thicknessndash Macrophage density
bull In vivo studiesndash Feasibilityndash Post-MIndash Epidemiologyndash Prospective trials
M produce proteasesDegrade collagen and matrix
Impair structural integrity of cap
CD68 Immunoperoxidase
Cap
Lipid
Tearney Bouma et al Circulation 2003
Macrophage Studybull Can OCT quantify macrophage content
bull Methodsndash 26 diseased arterial segments from 17 cadavers
bull 7 Carotid 19 Aortandash OCT imagingndash Histology processing - CD68 SMA trichromendash Correlation of OCT with histologyndash 500x125 microm ROIndash Histology - automatic segmentation - area stainingndash OCT - quantitative image analysis
NSD
Smax Smin
Tearney Bouma et al Circulation 2003
Macrophage Study
250 microm
OCT
CD68
Low M High M
Tearney Bouma et al Circulation 2003
Linear NSD vs CD68
CD68 area gt 10 - NSD cutoff 62
R = 084P lt 00001
Tearney Bouma et al Circulation 2003
Human Coronary Artery In Vivo
P
G
L
F
G
2x
ma
i
iel eel
F
OCT IVUS
Tearney Bouma et al Circulation 2003
Calcified Plaques In Vivo
OCT IVUS
Tearney Bouma et al Circulation 2003
Lipid-rich Plaque In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Thrombus In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Conclusionbull Intracoronary OCT represents a new
technology for microscale imaging of atherosclerotic plaque
bull In exvivo studies OCT can identify macrophage intensity in plaque cap
bull Given above OCT can be an important addition to cardiovascular cat labs may completely replace IVUS catheter
Questions
I Presence of blood induces artifacts for OCT imaging knowing the time constraint in cath labs the question is how practically OCT catheter can be utilized for screening vulnerable plaques throughout total coronary arteries
Questionsbull Assuming the limited use of IVUS
(lt20) for plaque characterization in cath labs is due to cost issue would OCT with equal price be cost effective
bull With the trend towards non-invasive diagnosis and using invasive procedure only for therapy how will OCT be greeted by interventional cardiologists
ReferencesReferences
1- Fujimoto JG Boppart SA Tearney GJ Bouma BE Pitris C Brezinski ME High resolution in vivo intra-arterial imaging with optical coherence tomography Heart 1999 Aug82(2)128-33
2- Brezinski ME Tearney GJ Weissman NJ Boppart SA Bouma BE Hee MR Weyman AE Swanson EA Southern JF Fujimoto JG Assessing atherosclerotic plaque morphology comparison of optical coherence tomography and high frequency intravascular ultrasound Heart 1997 May77(5)397-403
3- Ik-Kyung Jang Brett E Bouma Dong-Heon Kang Seung-Jung Park Seong-Wook Park Ki-Bae Seung Kyu-Bo Choi Milen Shishkov Kelly Schlendorf Eugene Pomerantsev et al Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography comparison with intravascular ultrasound Pages 604-609 Journal of the American College of Cardiology 2002 Volume 39(4) 604-609
4- Tearney GJ Jang IK Kang DH Aretz HT Houser SL Brady TJ Schlendorf K Shishkov M BoumaBE Porcine coronary imaging in vivo by optical coherence tomography Acta Cardiol 2000 Aug55(4)233-7
5- Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography Tearney Guillermo Yabushita Hiroshi Houser Stuart Aretz H Jang Ik-kyung Schlendorf Kelly Kauffman Christopher Shishkov Milen Halpern Elkan Bouma Brett Circulation 2003107113
- Editorial Slides VP Watch January 15 2003 Volume 1 Issue 2
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Plaque Characterization Study
- Plaque Characterization
- Plaque Characterization Results
- Slide 12
- Macrophage Study
- Slide 14
- Linear NSD vs CD68
- Human Coronary Artery In Vivo
- Calcified Plaques In Vivo
- Lipid-rich Plaque In Vivo
- Thrombus In Vivo
- Conclusion
- Questions
- Slide 22
- Slide 23
-
Brezinski Tearney Bouma Fujimoto and colleagues in 1997 discussed the advantages of OCT as following
bull High resolution bull Broad dynamic range and bull Ability to be delivered through
intravascular catheters 2
ndash In vitro studies have shown that the resolution of OCT (10-20 micron) can resolve the thin fibrous caps thought to be responsible for plaque vulnerability 1
ndash Catheter-based diagnostic techniques can provide structural information with higher resolution than non-invasive methods OCT achieves at least 10 times higher resolution than IVUS and can be adapted for catheter-based imaging of vulnerable plaque 3
IVUS OCT
Coronary IVUS vs Coronary OCT
Tearney Boma Chang et al
Tearney Jang and colleagues showed that in vivo OCT imaging of normal coronary arteries intimal dissections and deployed stents in swine is feasible and allows identification of clinically relevant coronary artery morphology with high-resolution and contrast 4
bull As highlighted in VP Watch of this week Tearney and colleagues showed OCT can characterize structure of atherosclerotic plaque ex-vivo5
bull They further showed that macrophage content of plaque cap can be identified by OCT 5
bull Ex vivo studiesndash Plaque characterizationndash Cap thicknessndash Macrophage density
bull In vivo studiesndash Feasibilityndash Post-MI
Fibrous
Calcific
LIPID
Yabushita Tearney et al Circulation 2002
Plaque Characterization Studybull Evaluate diagnostic potential (lipid pools)
bull Methodsndash 357 diseased arterial segments from 90 cadavers
bull 78 Coronary 86 Carotid 143 Aortandash OCT imaging histology processing registrationndash Correlation of OCT with histology
ndash Develop OCT criteria for characterization (training set n=50)ndash Prospectively test OCT criteria (validation set n = 307)ndash Two OCT readers and two pathologists
Yabushita Tearney et al Circulation 2002
Plaque Characterization
lp
lp
HomogeneousSignal-rich
Fibrous Lipid pool
Echolucent Diffuse Borders
Echolucent Sharp Borders
CalcificOCT Criteria training set (n=50)
500 microm
Plaque Characterization Results
SENS 79SPEC 97
SENS 95SPEC 97
SENS 90SPEC 92
bull Accuracy Statistics
bull Fibrous
bull Calcific
bull Lipid pool
Interobserver = 088 Intraobserver = 091 Yabushita Tearney et al Circulation 2002
bull Technology development
bull Ex vivo studiesndash Plaque characterizationndash Cap thicknessndash Macrophage density
bull In vivo studiesndash Feasibilityndash Post-MIndash Epidemiologyndash Prospective trials
M produce proteasesDegrade collagen and matrix
Impair structural integrity of cap
CD68 Immunoperoxidase
Cap
Lipid
Tearney Bouma et al Circulation 2003
Macrophage Studybull Can OCT quantify macrophage content
bull Methodsndash 26 diseased arterial segments from 17 cadavers
bull 7 Carotid 19 Aortandash OCT imagingndash Histology processing - CD68 SMA trichromendash Correlation of OCT with histologyndash 500x125 microm ROIndash Histology - automatic segmentation - area stainingndash OCT - quantitative image analysis
NSD
Smax Smin
Tearney Bouma et al Circulation 2003
Macrophage Study
250 microm
OCT
CD68
Low M High M
Tearney Bouma et al Circulation 2003
Linear NSD vs CD68
CD68 area gt 10 - NSD cutoff 62
R = 084P lt 00001
Tearney Bouma et al Circulation 2003
Human Coronary Artery In Vivo
P
G
L
F
G
2x
ma
i
iel eel
F
OCT IVUS
Tearney Bouma et al Circulation 2003
Calcified Plaques In Vivo
OCT IVUS
Tearney Bouma et al Circulation 2003
Lipid-rich Plaque In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Thrombus In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Conclusionbull Intracoronary OCT represents a new
technology for microscale imaging of atherosclerotic plaque
bull In exvivo studies OCT can identify macrophage intensity in plaque cap
bull Given above OCT can be an important addition to cardiovascular cat labs may completely replace IVUS catheter
Questions
I Presence of blood induces artifacts for OCT imaging knowing the time constraint in cath labs the question is how practically OCT catheter can be utilized for screening vulnerable plaques throughout total coronary arteries
Questionsbull Assuming the limited use of IVUS
(lt20) for plaque characterization in cath labs is due to cost issue would OCT with equal price be cost effective
bull With the trend towards non-invasive diagnosis and using invasive procedure only for therapy how will OCT be greeted by interventional cardiologists
ReferencesReferences
1- Fujimoto JG Boppart SA Tearney GJ Bouma BE Pitris C Brezinski ME High resolution in vivo intra-arterial imaging with optical coherence tomography Heart 1999 Aug82(2)128-33
2- Brezinski ME Tearney GJ Weissman NJ Boppart SA Bouma BE Hee MR Weyman AE Swanson EA Southern JF Fujimoto JG Assessing atherosclerotic plaque morphology comparison of optical coherence tomography and high frequency intravascular ultrasound Heart 1997 May77(5)397-403
3- Ik-Kyung Jang Brett E Bouma Dong-Heon Kang Seung-Jung Park Seong-Wook Park Ki-Bae Seung Kyu-Bo Choi Milen Shishkov Kelly Schlendorf Eugene Pomerantsev et al Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography comparison with intravascular ultrasound Pages 604-609 Journal of the American College of Cardiology 2002 Volume 39(4) 604-609
4- Tearney GJ Jang IK Kang DH Aretz HT Houser SL Brady TJ Schlendorf K Shishkov M BoumaBE Porcine coronary imaging in vivo by optical coherence tomography Acta Cardiol 2000 Aug55(4)233-7
5- Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography Tearney Guillermo Yabushita Hiroshi Houser Stuart Aretz H Jang Ik-kyung Schlendorf Kelly Kauffman Christopher Shishkov Milen Halpern Elkan Bouma Brett Circulation 2003107113
- Editorial Slides VP Watch January 15 2003 Volume 1 Issue 2
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Plaque Characterization Study
- Plaque Characterization
- Plaque Characterization Results
- Slide 12
- Macrophage Study
- Slide 14
- Linear NSD vs CD68
- Human Coronary Artery In Vivo
- Calcified Plaques In Vivo
- Lipid-rich Plaque In Vivo
- Thrombus In Vivo
- Conclusion
- Questions
- Slide 22
- Slide 23
-
ndash In vitro studies have shown that the resolution of OCT (10-20 micron) can resolve the thin fibrous caps thought to be responsible for plaque vulnerability 1
ndash Catheter-based diagnostic techniques can provide structural information with higher resolution than non-invasive methods OCT achieves at least 10 times higher resolution than IVUS and can be adapted for catheter-based imaging of vulnerable plaque 3
IVUS OCT
Coronary IVUS vs Coronary OCT
Tearney Boma Chang et al
Tearney Jang and colleagues showed that in vivo OCT imaging of normal coronary arteries intimal dissections and deployed stents in swine is feasible and allows identification of clinically relevant coronary artery morphology with high-resolution and contrast 4
bull As highlighted in VP Watch of this week Tearney and colleagues showed OCT can characterize structure of atherosclerotic plaque ex-vivo5
bull They further showed that macrophage content of plaque cap can be identified by OCT 5
bull Ex vivo studiesndash Plaque characterizationndash Cap thicknessndash Macrophage density
bull In vivo studiesndash Feasibilityndash Post-MI
Fibrous
Calcific
LIPID
Yabushita Tearney et al Circulation 2002
Plaque Characterization Studybull Evaluate diagnostic potential (lipid pools)
bull Methodsndash 357 diseased arterial segments from 90 cadavers
bull 78 Coronary 86 Carotid 143 Aortandash OCT imaging histology processing registrationndash Correlation of OCT with histology
ndash Develop OCT criteria for characterization (training set n=50)ndash Prospectively test OCT criteria (validation set n = 307)ndash Two OCT readers and two pathologists
Yabushita Tearney et al Circulation 2002
Plaque Characterization
lp
lp
HomogeneousSignal-rich
Fibrous Lipid pool
Echolucent Diffuse Borders
Echolucent Sharp Borders
CalcificOCT Criteria training set (n=50)
500 microm
Plaque Characterization Results
SENS 79SPEC 97
SENS 95SPEC 97
SENS 90SPEC 92
bull Accuracy Statistics
bull Fibrous
bull Calcific
bull Lipid pool
Interobserver = 088 Intraobserver = 091 Yabushita Tearney et al Circulation 2002
bull Technology development
bull Ex vivo studiesndash Plaque characterizationndash Cap thicknessndash Macrophage density
bull In vivo studiesndash Feasibilityndash Post-MIndash Epidemiologyndash Prospective trials
M produce proteasesDegrade collagen and matrix
Impair structural integrity of cap
CD68 Immunoperoxidase
Cap
Lipid
Tearney Bouma et al Circulation 2003
Macrophage Studybull Can OCT quantify macrophage content
bull Methodsndash 26 diseased arterial segments from 17 cadavers
bull 7 Carotid 19 Aortandash OCT imagingndash Histology processing - CD68 SMA trichromendash Correlation of OCT with histologyndash 500x125 microm ROIndash Histology - automatic segmentation - area stainingndash OCT - quantitative image analysis
NSD
Smax Smin
Tearney Bouma et al Circulation 2003
Macrophage Study
250 microm
OCT
CD68
Low M High M
Tearney Bouma et al Circulation 2003
Linear NSD vs CD68
CD68 area gt 10 - NSD cutoff 62
R = 084P lt 00001
Tearney Bouma et al Circulation 2003
Human Coronary Artery In Vivo
P
G
L
F
G
2x
ma
i
iel eel
F
OCT IVUS
Tearney Bouma et al Circulation 2003
Calcified Plaques In Vivo
OCT IVUS
Tearney Bouma et al Circulation 2003
Lipid-rich Plaque In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Thrombus In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Conclusionbull Intracoronary OCT represents a new
technology for microscale imaging of atherosclerotic plaque
bull In exvivo studies OCT can identify macrophage intensity in plaque cap
bull Given above OCT can be an important addition to cardiovascular cat labs may completely replace IVUS catheter
Questions
I Presence of blood induces artifacts for OCT imaging knowing the time constraint in cath labs the question is how practically OCT catheter can be utilized for screening vulnerable plaques throughout total coronary arteries
Questionsbull Assuming the limited use of IVUS
(lt20) for plaque characterization in cath labs is due to cost issue would OCT with equal price be cost effective
bull With the trend towards non-invasive diagnosis and using invasive procedure only for therapy how will OCT be greeted by interventional cardiologists
ReferencesReferences
1- Fujimoto JG Boppart SA Tearney GJ Bouma BE Pitris C Brezinski ME High resolution in vivo intra-arterial imaging with optical coherence tomography Heart 1999 Aug82(2)128-33
2- Brezinski ME Tearney GJ Weissman NJ Boppart SA Bouma BE Hee MR Weyman AE Swanson EA Southern JF Fujimoto JG Assessing atherosclerotic plaque morphology comparison of optical coherence tomography and high frequency intravascular ultrasound Heart 1997 May77(5)397-403
3- Ik-Kyung Jang Brett E Bouma Dong-Heon Kang Seung-Jung Park Seong-Wook Park Ki-Bae Seung Kyu-Bo Choi Milen Shishkov Kelly Schlendorf Eugene Pomerantsev et al Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography comparison with intravascular ultrasound Pages 604-609 Journal of the American College of Cardiology 2002 Volume 39(4) 604-609
4- Tearney GJ Jang IK Kang DH Aretz HT Houser SL Brady TJ Schlendorf K Shishkov M BoumaBE Porcine coronary imaging in vivo by optical coherence tomography Acta Cardiol 2000 Aug55(4)233-7
5- Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography Tearney Guillermo Yabushita Hiroshi Houser Stuart Aretz H Jang Ik-kyung Schlendorf Kelly Kauffman Christopher Shishkov Milen Halpern Elkan Bouma Brett Circulation 2003107113
- Editorial Slides VP Watch January 15 2003 Volume 1 Issue 2
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Plaque Characterization Study
- Plaque Characterization
- Plaque Characterization Results
- Slide 12
- Macrophage Study
- Slide 14
- Linear NSD vs CD68
- Human Coronary Artery In Vivo
- Calcified Plaques In Vivo
- Lipid-rich Plaque In Vivo
- Thrombus In Vivo
- Conclusion
- Questions
- Slide 22
- Slide 23
-
IVUS OCT
Coronary IVUS vs Coronary OCT
Tearney Boma Chang et al
Tearney Jang and colleagues showed that in vivo OCT imaging of normal coronary arteries intimal dissections and deployed stents in swine is feasible and allows identification of clinically relevant coronary artery morphology with high-resolution and contrast 4
bull As highlighted in VP Watch of this week Tearney and colleagues showed OCT can characterize structure of atherosclerotic plaque ex-vivo5
bull They further showed that macrophage content of plaque cap can be identified by OCT 5
bull Ex vivo studiesndash Plaque characterizationndash Cap thicknessndash Macrophage density
bull In vivo studiesndash Feasibilityndash Post-MI
Fibrous
Calcific
LIPID
Yabushita Tearney et al Circulation 2002
Plaque Characterization Studybull Evaluate diagnostic potential (lipid pools)
bull Methodsndash 357 diseased arterial segments from 90 cadavers
bull 78 Coronary 86 Carotid 143 Aortandash OCT imaging histology processing registrationndash Correlation of OCT with histology
ndash Develop OCT criteria for characterization (training set n=50)ndash Prospectively test OCT criteria (validation set n = 307)ndash Two OCT readers and two pathologists
Yabushita Tearney et al Circulation 2002
Plaque Characterization
lp
lp
HomogeneousSignal-rich
Fibrous Lipid pool
Echolucent Diffuse Borders
Echolucent Sharp Borders
CalcificOCT Criteria training set (n=50)
500 microm
Plaque Characterization Results
SENS 79SPEC 97
SENS 95SPEC 97
SENS 90SPEC 92
bull Accuracy Statistics
bull Fibrous
bull Calcific
bull Lipid pool
Interobserver = 088 Intraobserver = 091 Yabushita Tearney et al Circulation 2002
bull Technology development
bull Ex vivo studiesndash Plaque characterizationndash Cap thicknessndash Macrophage density
bull In vivo studiesndash Feasibilityndash Post-MIndash Epidemiologyndash Prospective trials
M produce proteasesDegrade collagen and matrix
Impair structural integrity of cap
CD68 Immunoperoxidase
Cap
Lipid
Tearney Bouma et al Circulation 2003
Macrophage Studybull Can OCT quantify macrophage content
bull Methodsndash 26 diseased arterial segments from 17 cadavers
bull 7 Carotid 19 Aortandash OCT imagingndash Histology processing - CD68 SMA trichromendash Correlation of OCT with histologyndash 500x125 microm ROIndash Histology - automatic segmentation - area stainingndash OCT - quantitative image analysis
NSD
Smax Smin
Tearney Bouma et al Circulation 2003
Macrophage Study
250 microm
OCT
CD68
Low M High M
Tearney Bouma et al Circulation 2003
Linear NSD vs CD68
CD68 area gt 10 - NSD cutoff 62
R = 084P lt 00001
Tearney Bouma et al Circulation 2003
Human Coronary Artery In Vivo
P
G
L
F
G
2x
ma
i
iel eel
F
OCT IVUS
Tearney Bouma et al Circulation 2003
Calcified Plaques In Vivo
OCT IVUS
Tearney Bouma et al Circulation 2003
Lipid-rich Plaque In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Thrombus In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Conclusionbull Intracoronary OCT represents a new
technology for microscale imaging of atherosclerotic plaque
bull In exvivo studies OCT can identify macrophage intensity in plaque cap
bull Given above OCT can be an important addition to cardiovascular cat labs may completely replace IVUS catheter
Questions
I Presence of blood induces artifacts for OCT imaging knowing the time constraint in cath labs the question is how practically OCT catheter can be utilized for screening vulnerable plaques throughout total coronary arteries
Questionsbull Assuming the limited use of IVUS
(lt20) for plaque characterization in cath labs is due to cost issue would OCT with equal price be cost effective
bull With the trend towards non-invasive diagnosis and using invasive procedure only for therapy how will OCT be greeted by interventional cardiologists
ReferencesReferences
1- Fujimoto JG Boppart SA Tearney GJ Bouma BE Pitris C Brezinski ME High resolution in vivo intra-arterial imaging with optical coherence tomography Heart 1999 Aug82(2)128-33
2- Brezinski ME Tearney GJ Weissman NJ Boppart SA Bouma BE Hee MR Weyman AE Swanson EA Southern JF Fujimoto JG Assessing atherosclerotic plaque morphology comparison of optical coherence tomography and high frequency intravascular ultrasound Heart 1997 May77(5)397-403
3- Ik-Kyung Jang Brett E Bouma Dong-Heon Kang Seung-Jung Park Seong-Wook Park Ki-Bae Seung Kyu-Bo Choi Milen Shishkov Kelly Schlendorf Eugene Pomerantsev et al Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography comparison with intravascular ultrasound Pages 604-609 Journal of the American College of Cardiology 2002 Volume 39(4) 604-609
4- Tearney GJ Jang IK Kang DH Aretz HT Houser SL Brady TJ Schlendorf K Shishkov M BoumaBE Porcine coronary imaging in vivo by optical coherence tomography Acta Cardiol 2000 Aug55(4)233-7
5- Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography Tearney Guillermo Yabushita Hiroshi Houser Stuart Aretz H Jang Ik-kyung Schlendorf Kelly Kauffman Christopher Shishkov Milen Halpern Elkan Bouma Brett Circulation 2003107113
- Editorial Slides VP Watch January 15 2003 Volume 1 Issue 2
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Plaque Characterization Study
- Plaque Characterization
- Plaque Characterization Results
- Slide 12
- Macrophage Study
- Slide 14
- Linear NSD vs CD68
- Human Coronary Artery In Vivo
- Calcified Plaques In Vivo
- Lipid-rich Plaque In Vivo
- Thrombus In Vivo
- Conclusion
- Questions
- Slide 22
- Slide 23
-
Tearney Jang and colleagues showed that in vivo OCT imaging of normal coronary arteries intimal dissections and deployed stents in swine is feasible and allows identification of clinically relevant coronary artery morphology with high-resolution and contrast 4
bull As highlighted in VP Watch of this week Tearney and colleagues showed OCT can characterize structure of atherosclerotic plaque ex-vivo5
bull They further showed that macrophage content of plaque cap can be identified by OCT 5
bull Ex vivo studiesndash Plaque characterizationndash Cap thicknessndash Macrophage density
bull In vivo studiesndash Feasibilityndash Post-MI
Fibrous
Calcific
LIPID
Yabushita Tearney et al Circulation 2002
Plaque Characterization Studybull Evaluate diagnostic potential (lipid pools)
bull Methodsndash 357 diseased arterial segments from 90 cadavers
bull 78 Coronary 86 Carotid 143 Aortandash OCT imaging histology processing registrationndash Correlation of OCT with histology
ndash Develop OCT criteria for characterization (training set n=50)ndash Prospectively test OCT criteria (validation set n = 307)ndash Two OCT readers and two pathologists
Yabushita Tearney et al Circulation 2002
Plaque Characterization
lp
lp
HomogeneousSignal-rich
Fibrous Lipid pool
Echolucent Diffuse Borders
Echolucent Sharp Borders
CalcificOCT Criteria training set (n=50)
500 microm
Plaque Characterization Results
SENS 79SPEC 97
SENS 95SPEC 97
SENS 90SPEC 92
bull Accuracy Statistics
bull Fibrous
bull Calcific
bull Lipid pool
Interobserver = 088 Intraobserver = 091 Yabushita Tearney et al Circulation 2002
bull Technology development
bull Ex vivo studiesndash Plaque characterizationndash Cap thicknessndash Macrophage density
bull In vivo studiesndash Feasibilityndash Post-MIndash Epidemiologyndash Prospective trials
M produce proteasesDegrade collagen and matrix
Impair structural integrity of cap
CD68 Immunoperoxidase
Cap
Lipid
Tearney Bouma et al Circulation 2003
Macrophage Studybull Can OCT quantify macrophage content
bull Methodsndash 26 diseased arterial segments from 17 cadavers
bull 7 Carotid 19 Aortandash OCT imagingndash Histology processing - CD68 SMA trichromendash Correlation of OCT with histologyndash 500x125 microm ROIndash Histology - automatic segmentation - area stainingndash OCT - quantitative image analysis
NSD
Smax Smin
Tearney Bouma et al Circulation 2003
Macrophage Study
250 microm
OCT
CD68
Low M High M
Tearney Bouma et al Circulation 2003
Linear NSD vs CD68
CD68 area gt 10 - NSD cutoff 62
R = 084P lt 00001
Tearney Bouma et al Circulation 2003
Human Coronary Artery In Vivo
P
G
L
F
G
2x
ma
i
iel eel
F
OCT IVUS
Tearney Bouma et al Circulation 2003
Calcified Plaques In Vivo
OCT IVUS
Tearney Bouma et al Circulation 2003
Lipid-rich Plaque In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Thrombus In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Conclusionbull Intracoronary OCT represents a new
technology for microscale imaging of atherosclerotic plaque
bull In exvivo studies OCT can identify macrophage intensity in plaque cap
bull Given above OCT can be an important addition to cardiovascular cat labs may completely replace IVUS catheter
Questions
I Presence of blood induces artifacts for OCT imaging knowing the time constraint in cath labs the question is how practically OCT catheter can be utilized for screening vulnerable plaques throughout total coronary arteries
Questionsbull Assuming the limited use of IVUS
(lt20) for plaque characterization in cath labs is due to cost issue would OCT with equal price be cost effective
bull With the trend towards non-invasive diagnosis and using invasive procedure only for therapy how will OCT be greeted by interventional cardiologists
ReferencesReferences
1- Fujimoto JG Boppart SA Tearney GJ Bouma BE Pitris C Brezinski ME High resolution in vivo intra-arterial imaging with optical coherence tomography Heart 1999 Aug82(2)128-33
2- Brezinski ME Tearney GJ Weissman NJ Boppart SA Bouma BE Hee MR Weyman AE Swanson EA Southern JF Fujimoto JG Assessing atherosclerotic plaque morphology comparison of optical coherence tomography and high frequency intravascular ultrasound Heart 1997 May77(5)397-403
3- Ik-Kyung Jang Brett E Bouma Dong-Heon Kang Seung-Jung Park Seong-Wook Park Ki-Bae Seung Kyu-Bo Choi Milen Shishkov Kelly Schlendorf Eugene Pomerantsev et al Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography comparison with intravascular ultrasound Pages 604-609 Journal of the American College of Cardiology 2002 Volume 39(4) 604-609
4- Tearney GJ Jang IK Kang DH Aretz HT Houser SL Brady TJ Schlendorf K Shishkov M BoumaBE Porcine coronary imaging in vivo by optical coherence tomography Acta Cardiol 2000 Aug55(4)233-7
5- Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography Tearney Guillermo Yabushita Hiroshi Houser Stuart Aretz H Jang Ik-kyung Schlendorf Kelly Kauffman Christopher Shishkov Milen Halpern Elkan Bouma Brett Circulation 2003107113
- Editorial Slides VP Watch January 15 2003 Volume 1 Issue 2
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Plaque Characterization Study
- Plaque Characterization
- Plaque Characterization Results
- Slide 12
- Macrophage Study
- Slide 14
- Linear NSD vs CD68
- Human Coronary Artery In Vivo
- Calcified Plaques In Vivo
- Lipid-rich Plaque In Vivo
- Thrombus In Vivo
- Conclusion
- Questions
- Slide 22
- Slide 23
-
bull As highlighted in VP Watch of this week Tearney and colleagues showed OCT can characterize structure of atherosclerotic plaque ex-vivo5
bull They further showed that macrophage content of plaque cap can be identified by OCT 5
bull Ex vivo studiesndash Plaque characterizationndash Cap thicknessndash Macrophage density
bull In vivo studiesndash Feasibilityndash Post-MI
Fibrous
Calcific
LIPID
Yabushita Tearney et al Circulation 2002
Plaque Characterization Studybull Evaluate diagnostic potential (lipid pools)
bull Methodsndash 357 diseased arterial segments from 90 cadavers
bull 78 Coronary 86 Carotid 143 Aortandash OCT imaging histology processing registrationndash Correlation of OCT with histology
ndash Develop OCT criteria for characterization (training set n=50)ndash Prospectively test OCT criteria (validation set n = 307)ndash Two OCT readers and two pathologists
Yabushita Tearney et al Circulation 2002
Plaque Characterization
lp
lp
HomogeneousSignal-rich
Fibrous Lipid pool
Echolucent Diffuse Borders
Echolucent Sharp Borders
CalcificOCT Criteria training set (n=50)
500 microm
Plaque Characterization Results
SENS 79SPEC 97
SENS 95SPEC 97
SENS 90SPEC 92
bull Accuracy Statistics
bull Fibrous
bull Calcific
bull Lipid pool
Interobserver = 088 Intraobserver = 091 Yabushita Tearney et al Circulation 2002
bull Technology development
bull Ex vivo studiesndash Plaque characterizationndash Cap thicknessndash Macrophage density
bull In vivo studiesndash Feasibilityndash Post-MIndash Epidemiologyndash Prospective trials
M produce proteasesDegrade collagen and matrix
Impair structural integrity of cap
CD68 Immunoperoxidase
Cap
Lipid
Tearney Bouma et al Circulation 2003
Macrophage Studybull Can OCT quantify macrophage content
bull Methodsndash 26 diseased arterial segments from 17 cadavers
bull 7 Carotid 19 Aortandash OCT imagingndash Histology processing - CD68 SMA trichromendash Correlation of OCT with histologyndash 500x125 microm ROIndash Histology - automatic segmentation - area stainingndash OCT - quantitative image analysis
NSD
Smax Smin
Tearney Bouma et al Circulation 2003
Macrophage Study
250 microm
OCT
CD68
Low M High M
Tearney Bouma et al Circulation 2003
Linear NSD vs CD68
CD68 area gt 10 - NSD cutoff 62
R = 084P lt 00001
Tearney Bouma et al Circulation 2003
Human Coronary Artery In Vivo
P
G
L
F
G
2x
ma
i
iel eel
F
OCT IVUS
Tearney Bouma et al Circulation 2003
Calcified Plaques In Vivo
OCT IVUS
Tearney Bouma et al Circulation 2003
Lipid-rich Plaque In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Thrombus In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Conclusionbull Intracoronary OCT represents a new
technology for microscale imaging of atherosclerotic plaque
bull In exvivo studies OCT can identify macrophage intensity in plaque cap
bull Given above OCT can be an important addition to cardiovascular cat labs may completely replace IVUS catheter
Questions
I Presence of blood induces artifacts for OCT imaging knowing the time constraint in cath labs the question is how practically OCT catheter can be utilized for screening vulnerable plaques throughout total coronary arteries
Questionsbull Assuming the limited use of IVUS
(lt20) for plaque characterization in cath labs is due to cost issue would OCT with equal price be cost effective
bull With the trend towards non-invasive diagnosis and using invasive procedure only for therapy how will OCT be greeted by interventional cardiologists
ReferencesReferences
1- Fujimoto JG Boppart SA Tearney GJ Bouma BE Pitris C Brezinski ME High resolution in vivo intra-arterial imaging with optical coherence tomography Heart 1999 Aug82(2)128-33
2- Brezinski ME Tearney GJ Weissman NJ Boppart SA Bouma BE Hee MR Weyman AE Swanson EA Southern JF Fujimoto JG Assessing atherosclerotic plaque morphology comparison of optical coherence tomography and high frequency intravascular ultrasound Heart 1997 May77(5)397-403
3- Ik-Kyung Jang Brett E Bouma Dong-Heon Kang Seung-Jung Park Seong-Wook Park Ki-Bae Seung Kyu-Bo Choi Milen Shishkov Kelly Schlendorf Eugene Pomerantsev et al Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography comparison with intravascular ultrasound Pages 604-609 Journal of the American College of Cardiology 2002 Volume 39(4) 604-609
4- Tearney GJ Jang IK Kang DH Aretz HT Houser SL Brady TJ Schlendorf K Shishkov M BoumaBE Porcine coronary imaging in vivo by optical coherence tomography Acta Cardiol 2000 Aug55(4)233-7
5- Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography Tearney Guillermo Yabushita Hiroshi Houser Stuart Aretz H Jang Ik-kyung Schlendorf Kelly Kauffman Christopher Shishkov Milen Halpern Elkan Bouma Brett Circulation 2003107113
- Editorial Slides VP Watch January 15 2003 Volume 1 Issue 2
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Plaque Characterization Study
- Plaque Characterization
- Plaque Characterization Results
- Slide 12
- Macrophage Study
- Slide 14
- Linear NSD vs CD68
- Human Coronary Artery In Vivo
- Calcified Plaques In Vivo
- Lipid-rich Plaque In Vivo
- Thrombus In Vivo
- Conclusion
- Questions
- Slide 22
- Slide 23
-
bull Ex vivo studiesndash Plaque characterizationndash Cap thicknessndash Macrophage density
bull In vivo studiesndash Feasibilityndash Post-MI
Fibrous
Calcific
LIPID
Yabushita Tearney et al Circulation 2002
Plaque Characterization Studybull Evaluate diagnostic potential (lipid pools)
bull Methodsndash 357 diseased arterial segments from 90 cadavers
bull 78 Coronary 86 Carotid 143 Aortandash OCT imaging histology processing registrationndash Correlation of OCT with histology
ndash Develop OCT criteria for characterization (training set n=50)ndash Prospectively test OCT criteria (validation set n = 307)ndash Two OCT readers and two pathologists
Yabushita Tearney et al Circulation 2002
Plaque Characterization
lp
lp
HomogeneousSignal-rich
Fibrous Lipid pool
Echolucent Diffuse Borders
Echolucent Sharp Borders
CalcificOCT Criteria training set (n=50)
500 microm
Plaque Characterization Results
SENS 79SPEC 97
SENS 95SPEC 97
SENS 90SPEC 92
bull Accuracy Statistics
bull Fibrous
bull Calcific
bull Lipid pool
Interobserver = 088 Intraobserver = 091 Yabushita Tearney et al Circulation 2002
bull Technology development
bull Ex vivo studiesndash Plaque characterizationndash Cap thicknessndash Macrophage density
bull In vivo studiesndash Feasibilityndash Post-MIndash Epidemiologyndash Prospective trials
M produce proteasesDegrade collagen and matrix
Impair structural integrity of cap
CD68 Immunoperoxidase
Cap
Lipid
Tearney Bouma et al Circulation 2003
Macrophage Studybull Can OCT quantify macrophage content
bull Methodsndash 26 diseased arterial segments from 17 cadavers
bull 7 Carotid 19 Aortandash OCT imagingndash Histology processing - CD68 SMA trichromendash Correlation of OCT with histologyndash 500x125 microm ROIndash Histology - automatic segmentation - area stainingndash OCT - quantitative image analysis
NSD
Smax Smin
Tearney Bouma et al Circulation 2003
Macrophage Study
250 microm
OCT
CD68
Low M High M
Tearney Bouma et al Circulation 2003
Linear NSD vs CD68
CD68 area gt 10 - NSD cutoff 62
R = 084P lt 00001
Tearney Bouma et al Circulation 2003
Human Coronary Artery In Vivo
P
G
L
F
G
2x
ma
i
iel eel
F
OCT IVUS
Tearney Bouma et al Circulation 2003
Calcified Plaques In Vivo
OCT IVUS
Tearney Bouma et al Circulation 2003
Lipid-rich Plaque In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Thrombus In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Conclusionbull Intracoronary OCT represents a new
technology for microscale imaging of atherosclerotic plaque
bull In exvivo studies OCT can identify macrophage intensity in plaque cap
bull Given above OCT can be an important addition to cardiovascular cat labs may completely replace IVUS catheter
Questions
I Presence of blood induces artifacts for OCT imaging knowing the time constraint in cath labs the question is how practically OCT catheter can be utilized for screening vulnerable plaques throughout total coronary arteries
Questionsbull Assuming the limited use of IVUS
(lt20) for plaque characterization in cath labs is due to cost issue would OCT with equal price be cost effective
bull With the trend towards non-invasive diagnosis and using invasive procedure only for therapy how will OCT be greeted by interventional cardiologists
ReferencesReferences
1- Fujimoto JG Boppart SA Tearney GJ Bouma BE Pitris C Brezinski ME High resolution in vivo intra-arterial imaging with optical coherence tomography Heart 1999 Aug82(2)128-33
2- Brezinski ME Tearney GJ Weissman NJ Boppart SA Bouma BE Hee MR Weyman AE Swanson EA Southern JF Fujimoto JG Assessing atherosclerotic plaque morphology comparison of optical coherence tomography and high frequency intravascular ultrasound Heart 1997 May77(5)397-403
3- Ik-Kyung Jang Brett E Bouma Dong-Heon Kang Seung-Jung Park Seong-Wook Park Ki-Bae Seung Kyu-Bo Choi Milen Shishkov Kelly Schlendorf Eugene Pomerantsev et al Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography comparison with intravascular ultrasound Pages 604-609 Journal of the American College of Cardiology 2002 Volume 39(4) 604-609
4- Tearney GJ Jang IK Kang DH Aretz HT Houser SL Brady TJ Schlendorf K Shishkov M BoumaBE Porcine coronary imaging in vivo by optical coherence tomography Acta Cardiol 2000 Aug55(4)233-7
5- Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography Tearney Guillermo Yabushita Hiroshi Houser Stuart Aretz H Jang Ik-kyung Schlendorf Kelly Kauffman Christopher Shishkov Milen Halpern Elkan Bouma Brett Circulation 2003107113
- Editorial Slides VP Watch January 15 2003 Volume 1 Issue 2
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Plaque Characterization Study
- Plaque Characterization
- Plaque Characterization Results
- Slide 12
- Macrophage Study
- Slide 14
- Linear NSD vs CD68
- Human Coronary Artery In Vivo
- Calcified Plaques In Vivo
- Lipid-rich Plaque In Vivo
- Thrombus In Vivo
- Conclusion
- Questions
- Slide 22
- Slide 23
-
Plaque Characterization Studybull Evaluate diagnostic potential (lipid pools)
bull Methodsndash 357 diseased arterial segments from 90 cadavers
bull 78 Coronary 86 Carotid 143 Aortandash OCT imaging histology processing registrationndash Correlation of OCT with histology
ndash Develop OCT criteria for characterization (training set n=50)ndash Prospectively test OCT criteria (validation set n = 307)ndash Two OCT readers and two pathologists
Yabushita Tearney et al Circulation 2002
Plaque Characterization
lp
lp
HomogeneousSignal-rich
Fibrous Lipid pool
Echolucent Diffuse Borders
Echolucent Sharp Borders
CalcificOCT Criteria training set (n=50)
500 microm
Plaque Characterization Results
SENS 79SPEC 97
SENS 95SPEC 97
SENS 90SPEC 92
bull Accuracy Statistics
bull Fibrous
bull Calcific
bull Lipid pool
Interobserver = 088 Intraobserver = 091 Yabushita Tearney et al Circulation 2002
bull Technology development
bull Ex vivo studiesndash Plaque characterizationndash Cap thicknessndash Macrophage density
bull In vivo studiesndash Feasibilityndash Post-MIndash Epidemiologyndash Prospective trials
M produce proteasesDegrade collagen and matrix
Impair structural integrity of cap
CD68 Immunoperoxidase
Cap
Lipid
Tearney Bouma et al Circulation 2003
Macrophage Studybull Can OCT quantify macrophage content
bull Methodsndash 26 diseased arterial segments from 17 cadavers
bull 7 Carotid 19 Aortandash OCT imagingndash Histology processing - CD68 SMA trichromendash Correlation of OCT with histologyndash 500x125 microm ROIndash Histology - automatic segmentation - area stainingndash OCT - quantitative image analysis
NSD
Smax Smin
Tearney Bouma et al Circulation 2003
Macrophage Study
250 microm
OCT
CD68
Low M High M
Tearney Bouma et al Circulation 2003
Linear NSD vs CD68
CD68 area gt 10 - NSD cutoff 62
R = 084P lt 00001
Tearney Bouma et al Circulation 2003
Human Coronary Artery In Vivo
P
G
L
F
G
2x
ma
i
iel eel
F
OCT IVUS
Tearney Bouma et al Circulation 2003
Calcified Plaques In Vivo
OCT IVUS
Tearney Bouma et al Circulation 2003
Lipid-rich Plaque In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Thrombus In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Conclusionbull Intracoronary OCT represents a new
technology for microscale imaging of atherosclerotic plaque
bull In exvivo studies OCT can identify macrophage intensity in plaque cap
bull Given above OCT can be an important addition to cardiovascular cat labs may completely replace IVUS catheter
Questions
I Presence of blood induces artifacts for OCT imaging knowing the time constraint in cath labs the question is how practically OCT catheter can be utilized for screening vulnerable plaques throughout total coronary arteries
Questionsbull Assuming the limited use of IVUS
(lt20) for plaque characterization in cath labs is due to cost issue would OCT with equal price be cost effective
bull With the trend towards non-invasive diagnosis and using invasive procedure only for therapy how will OCT be greeted by interventional cardiologists
ReferencesReferences
1- Fujimoto JG Boppart SA Tearney GJ Bouma BE Pitris C Brezinski ME High resolution in vivo intra-arterial imaging with optical coherence tomography Heart 1999 Aug82(2)128-33
2- Brezinski ME Tearney GJ Weissman NJ Boppart SA Bouma BE Hee MR Weyman AE Swanson EA Southern JF Fujimoto JG Assessing atherosclerotic plaque morphology comparison of optical coherence tomography and high frequency intravascular ultrasound Heart 1997 May77(5)397-403
3- Ik-Kyung Jang Brett E Bouma Dong-Heon Kang Seung-Jung Park Seong-Wook Park Ki-Bae Seung Kyu-Bo Choi Milen Shishkov Kelly Schlendorf Eugene Pomerantsev et al Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography comparison with intravascular ultrasound Pages 604-609 Journal of the American College of Cardiology 2002 Volume 39(4) 604-609
4- Tearney GJ Jang IK Kang DH Aretz HT Houser SL Brady TJ Schlendorf K Shishkov M BoumaBE Porcine coronary imaging in vivo by optical coherence tomography Acta Cardiol 2000 Aug55(4)233-7
5- Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography Tearney Guillermo Yabushita Hiroshi Houser Stuart Aretz H Jang Ik-kyung Schlendorf Kelly Kauffman Christopher Shishkov Milen Halpern Elkan Bouma Brett Circulation 2003107113
- Editorial Slides VP Watch January 15 2003 Volume 1 Issue 2
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Plaque Characterization Study
- Plaque Characterization
- Plaque Characterization Results
- Slide 12
- Macrophage Study
- Slide 14
- Linear NSD vs CD68
- Human Coronary Artery In Vivo
- Calcified Plaques In Vivo
- Lipid-rich Plaque In Vivo
- Thrombus In Vivo
- Conclusion
- Questions
- Slide 22
- Slide 23
-
Plaque Characterization
lp
lp
HomogeneousSignal-rich
Fibrous Lipid pool
Echolucent Diffuse Borders
Echolucent Sharp Borders
CalcificOCT Criteria training set (n=50)
500 microm
Plaque Characterization Results
SENS 79SPEC 97
SENS 95SPEC 97
SENS 90SPEC 92
bull Accuracy Statistics
bull Fibrous
bull Calcific
bull Lipid pool
Interobserver = 088 Intraobserver = 091 Yabushita Tearney et al Circulation 2002
bull Technology development
bull Ex vivo studiesndash Plaque characterizationndash Cap thicknessndash Macrophage density
bull In vivo studiesndash Feasibilityndash Post-MIndash Epidemiologyndash Prospective trials
M produce proteasesDegrade collagen and matrix
Impair structural integrity of cap
CD68 Immunoperoxidase
Cap
Lipid
Tearney Bouma et al Circulation 2003
Macrophage Studybull Can OCT quantify macrophage content
bull Methodsndash 26 diseased arterial segments from 17 cadavers
bull 7 Carotid 19 Aortandash OCT imagingndash Histology processing - CD68 SMA trichromendash Correlation of OCT with histologyndash 500x125 microm ROIndash Histology - automatic segmentation - area stainingndash OCT - quantitative image analysis
NSD
Smax Smin
Tearney Bouma et al Circulation 2003
Macrophage Study
250 microm
OCT
CD68
Low M High M
Tearney Bouma et al Circulation 2003
Linear NSD vs CD68
CD68 area gt 10 - NSD cutoff 62
R = 084P lt 00001
Tearney Bouma et al Circulation 2003
Human Coronary Artery In Vivo
P
G
L
F
G
2x
ma
i
iel eel
F
OCT IVUS
Tearney Bouma et al Circulation 2003
Calcified Plaques In Vivo
OCT IVUS
Tearney Bouma et al Circulation 2003
Lipid-rich Plaque In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Thrombus In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Conclusionbull Intracoronary OCT represents a new
technology for microscale imaging of atherosclerotic plaque
bull In exvivo studies OCT can identify macrophage intensity in plaque cap
bull Given above OCT can be an important addition to cardiovascular cat labs may completely replace IVUS catheter
Questions
I Presence of blood induces artifacts for OCT imaging knowing the time constraint in cath labs the question is how practically OCT catheter can be utilized for screening vulnerable plaques throughout total coronary arteries
Questionsbull Assuming the limited use of IVUS
(lt20) for plaque characterization in cath labs is due to cost issue would OCT with equal price be cost effective
bull With the trend towards non-invasive diagnosis and using invasive procedure only for therapy how will OCT be greeted by interventional cardiologists
ReferencesReferences
1- Fujimoto JG Boppart SA Tearney GJ Bouma BE Pitris C Brezinski ME High resolution in vivo intra-arterial imaging with optical coherence tomography Heart 1999 Aug82(2)128-33
2- Brezinski ME Tearney GJ Weissman NJ Boppart SA Bouma BE Hee MR Weyman AE Swanson EA Southern JF Fujimoto JG Assessing atherosclerotic plaque morphology comparison of optical coherence tomography and high frequency intravascular ultrasound Heart 1997 May77(5)397-403
3- Ik-Kyung Jang Brett E Bouma Dong-Heon Kang Seung-Jung Park Seong-Wook Park Ki-Bae Seung Kyu-Bo Choi Milen Shishkov Kelly Schlendorf Eugene Pomerantsev et al Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography comparison with intravascular ultrasound Pages 604-609 Journal of the American College of Cardiology 2002 Volume 39(4) 604-609
4- Tearney GJ Jang IK Kang DH Aretz HT Houser SL Brady TJ Schlendorf K Shishkov M BoumaBE Porcine coronary imaging in vivo by optical coherence tomography Acta Cardiol 2000 Aug55(4)233-7
5- Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography Tearney Guillermo Yabushita Hiroshi Houser Stuart Aretz H Jang Ik-kyung Schlendorf Kelly Kauffman Christopher Shishkov Milen Halpern Elkan Bouma Brett Circulation 2003107113
- Editorial Slides VP Watch January 15 2003 Volume 1 Issue 2
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Plaque Characterization Study
- Plaque Characterization
- Plaque Characterization Results
- Slide 12
- Macrophage Study
- Slide 14
- Linear NSD vs CD68
- Human Coronary Artery In Vivo
- Calcified Plaques In Vivo
- Lipid-rich Plaque In Vivo
- Thrombus In Vivo
- Conclusion
- Questions
- Slide 22
- Slide 23
-
Plaque Characterization Results
SENS 79SPEC 97
SENS 95SPEC 97
SENS 90SPEC 92
bull Accuracy Statistics
bull Fibrous
bull Calcific
bull Lipid pool
Interobserver = 088 Intraobserver = 091 Yabushita Tearney et al Circulation 2002
bull Technology development
bull Ex vivo studiesndash Plaque characterizationndash Cap thicknessndash Macrophage density
bull In vivo studiesndash Feasibilityndash Post-MIndash Epidemiologyndash Prospective trials
M produce proteasesDegrade collagen and matrix
Impair structural integrity of cap
CD68 Immunoperoxidase
Cap
Lipid
Tearney Bouma et al Circulation 2003
Macrophage Studybull Can OCT quantify macrophage content
bull Methodsndash 26 diseased arterial segments from 17 cadavers
bull 7 Carotid 19 Aortandash OCT imagingndash Histology processing - CD68 SMA trichromendash Correlation of OCT with histologyndash 500x125 microm ROIndash Histology - automatic segmentation - area stainingndash OCT - quantitative image analysis
NSD
Smax Smin
Tearney Bouma et al Circulation 2003
Macrophage Study
250 microm
OCT
CD68
Low M High M
Tearney Bouma et al Circulation 2003
Linear NSD vs CD68
CD68 area gt 10 - NSD cutoff 62
R = 084P lt 00001
Tearney Bouma et al Circulation 2003
Human Coronary Artery In Vivo
P
G
L
F
G
2x
ma
i
iel eel
F
OCT IVUS
Tearney Bouma et al Circulation 2003
Calcified Plaques In Vivo
OCT IVUS
Tearney Bouma et al Circulation 2003
Lipid-rich Plaque In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Thrombus In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Conclusionbull Intracoronary OCT represents a new
technology for microscale imaging of atherosclerotic plaque
bull In exvivo studies OCT can identify macrophage intensity in plaque cap
bull Given above OCT can be an important addition to cardiovascular cat labs may completely replace IVUS catheter
Questions
I Presence of blood induces artifacts for OCT imaging knowing the time constraint in cath labs the question is how practically OCT catheter can be utilized for screening vulnerable plaques throughout total coronary arteries
Questionsbull Assuming the limited use of IVUS
(lt20) for plaque characterization in cath labs is due to cost issue would OCT with equal price be cost effective
bull With the trend towards non-invasive diagnosis and using invasive procedure only for therapy how will OCT be greeted by interventional cardiologists
ReferencesReferences
1- Fujimoto JG Boppart SA Tearney GJ Bouma BE Pitris C Brezinski ME High resolution in vivo intra-arterial imaging with optical coherence tomography Heart 1999 Aug82(2)128-33
2- Brezinski ME Tearney GJ Weissman NJ Boppart SA Bouma BE Hee MR Weyman AE Swanson EA Southern JF Fujimoto JG Assessing atherosclerotic plaque morphology comparison of optical coherence tomography and high frequency intravascular ultrasound Heart 1997 May77(5)397-403
3- Ik-Kyung Jang Brett E Bouma Dong-Heon Kang Seung-Jung Park Seong-Wook Park Ki-Bae Seung Kyu-Bo Choi Milen Shishkov Kelly Schlendorf Eugene Pomerantsev et al Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography comparison with intravascular ultrasound Pages 604-609 Journal of the American College of Cardiology 2002 Volume 39(4) 604-609
4- Tearney GJ Jang IK Kang DH Aretz HT Houser SL Brady TJ Schlendorf K Shishkov M BoumaBE Porcine coronary imaging in vivo by optical coherence tomography Acta Cardiol 2000 Aug55(4)233-7
5- Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography Tearney Guillermo Yabushita Hiroshi Houser Stuart Aretz H Jang Ik-kyung Schlendorf Kelly Kauffman Christopher Shishkov Milen Halpern Elkan Bouma Brett Circulation 2003107113
- Editorial Slides VP Watch January 15 2003 Volume 1 Issue 2
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Plaque Characterization Study
- Plaque Characterization
- Plaque Characterization Results
- Slide 12
- Macrophage Study
- Slide 14
- Linear NSD vs CD68
- Human Coronary Artery In Vivo
- Calcified Plaques In Vivo
- Lipid-rich Plaque In Vivo
- Thrombus In Vivo
- Conclusion
- Questions
- Slide 22
- Slide 23
-
bull Technology development
bull Ex vivo studiesndash Plaque characterizationndash Cap thicknessndash Macrophage density
bull In vivo studiesndash Feasibilityndash Post-MIndash Epidemiologyndash Prospective trials
M produce proteasesDegrade collagen and matrix
Impair structural integrity of cap
CD68 Immunoperoxidase
Cap
Lipid
Tearney Bouma et al Circulation 2003
Macrophage Studybull Can OCT quantify macrophage content
bull Methodsndash 26 diseased arterial segments from 17 cadavers
bull 7 Carotid 19 Aortandash OCT imagingndash Histology processing - CD68 SMA trichromendash Correlation of OCT with histologyndash 500x125 microm ROIndash Histology - automatic segmentation - area stainingndash OCT - quantitative image analysis
NSD
Smax Smin
Tearney Bouma et al Circulation 2003
Macrophage Study
250 microm
OCT
CD68
Low M High M
Tearney Bouma et al Circulation 2003
Linear NSD vs CD68
CD68 area gt 10 - NSD cutoff 62
R = 084P lt 00001
Tearney Bouma et al Circulation 2003
Human Coronary Artery In Vivo
P
G
L
F
G
2x
ma
i
iel eel
F
OCT IVUS
Tearney Bouma et al Circulation 2003
Calcified Plaques In Vivo
OCT IVUS
Tearney Bouma et al Circulation 2003
Lipid-rich Plaque In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Thrombus In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Conclusionbull Intracoronary OCT represents a new
technology for microscale imaging of atherosclerotic plaque
bull In exvivo studies OCT can identify macrophage intensity in plaque cap
bull Given above OCT can be an important addition to cardiovascular cat labs may completely replace IVUS catheter
Questions
I Presence of blood induces artifacts for OCT imaging knowing the time constraint in cath labs the question is how practically OCT catheter can be utilized for screening vulnerable plaques throughout total coronary arteries
Questionsbull Assuming the limited use of IVUS
(lt20) for plaque characterization in cath labs is due to cost issue would OCT with equal price be cost effective
bull With the trend towards non-invasive diagnosis and using invasive procedure only for therapy how will OCT be greeted by interventional cardiologists
ReferencesReferences
1- Fujimoto JG Boppart SA Tearney GJ Bouma BE Pitris C Brezinski ME High resolution in vivo intra-arterial imaging with optical coherence tomography Heart 1999 Aug82(2)128-33
2- Brezinski ME Tearney GJ Weissman NJ Boppart SA Bouma BE Hee MR Weyman AE Swanson EA Southern JF Fujimoto JG Assessing atherosclerotic plaque morphology comparison of optical coherence tomography and high frequency intravascular ultrasound Heart 1997 May77(5)397-403
3- Ik-Kyung Jang Brett E Bouma Dong-Heon Kang Seung-Jung Park Seong-Wook Park Ki-Bae Seung Kyu-Bo Choi Milen Shishkov Kelly Schlendorf Eugene Pomerantsev et al Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography comparison with intravascular ultrasound Pages 604-609 Journal of the American College of Cardiology 2002 Volume 39(4) 604-609
4- Tearney GJ Jang IK Kang DH Aretz HT Houser SL Brady TJ Schlendorf K Shishkov M BoumaBE Porcine coronary imaging in vivo by optical coherence tomography Acta Cardiol 2000 Aug55(4)233-7
5- Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography Tearney Guillermo Yabushita Hiroshi Houser Stuart Aretz H Jang Ik-kyung Schlendorf Kelly Kauffman Christopher Shishkov Milen Halpern Elkan Bouma Brett Circulation 2003107113
- Editorial Slides VP Watch January 15 2003 Volume 1 Issue 2
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Plaque Characterization Study
- Plaque Characterization
- Plaque Characterization Results
- Slide 12
- Macrophage Study
- Slide 14
- Linear NSD vs CD68
- Human Coronary Artery In Vivo
- Calcified Plaques In Vivo
- Lipid-rich Plaque In Vivo
- Thrombus In Vivo
- Conclusion
- Questions
- Slide 22
- Slide 23
-
Macrophage Studybull Can OCT quantify macrophage content
bull Methodsndash 26 diseased arterial segments from 17 cadavers
bull 7 Carotid 19 Aortandash OCT imagingndash Histology processing - CD68 SMA trichromendash Correlation of OCT with histologyndash 500x125 microm ROIndash Histology - automatic segmentation - area stainingndash OCT - quantitative image analysis
NSD
Smax Smin
Tearney Bouma et al Circulation 2003
Macrophage Study
250 microm
OCT
CD68
Low M High M
Tearney Bouma et al Circulation 2003
Linear NSD vs CD68
CD68 area gt 10 - NSD cutoff 62
R = 084P lt 00001
Tearney Bouma et al Circulation 2003
Human Coronary Artery In Vivo
P
G
L
F
G
2x
ma
i
iel eel
F
OCT IVUS
Tearney Bouma et al Circulation 2003
Calcified Plaques In Vivo
OCT IVUS
Tearney Bouma et al Circulation 2003
Lipid-rich Plaque In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Thrombus In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Conclusionbull Intracoronary OCT represents a new
technology for microscale imaging of atherosclerotic plaque
bull In exvivo studies OCT can identify macrophage intensity in plaque cap
bull Given above OCT can be an important addition to cardiovascular cat labs may completely replace IVUS catheter
Questions
I Presence of blood induces artifacts for OCT imaging knowing the time constraint in cath labs the question is how practically OCT catheter can be utilized for screening vulnerable plaques throughout total coronary arteries
Questionsbull Assuming the limited use of IVUS
(lt20) for plaque characterization in cath labs is due to cost issue would OCT with equal price be cost effective
bull With the trend towards non-invasive diagnosis and using invasive procedure only for therapy how will OCT be greeted by interventional cardiologists
ReferencesReferences
1- Fujimoto JG Boppart SA Tearney GJ Bouma BE Pitris C Brezinski ME High resolution in vivo intra-arterial imaging with optical coherence tomography Heart 1999 Aug82(2)128-33
2- Brezinski ME Tearney GJ Weissman NJ Boppart SA Bouma BE Hee MR Weyman AE Swanson EA Southern JF Fujimoto JG Assessing atherosclerotic plaque morphology comparison of optical coherence tomography and high frequency intravascular ultrasound Heart 1997 May77(5)397-403
3- Ik-Kyung Jang Brett E Bouma Dong-Heon Kang Seung-Jung Park Seong-Wook Park Ki-Bae Seung Kyu-Bo Choi Milen Shishkov Kelly Schlendorf Eugene Pomerantsev et al Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography comparison with intravascular ultrasound Pages 604-609 Journal of the American College of Cardiology 2002 Volume 39(4) 604-609
4- Tearney GJ Jang IK Kang DH Aretz HT Houser SL Brady TJ Schlendorf K Shishkov M BoumaBE Porcine coronary imaging in vivo by optical coherence tomography Acta Cardiol 2000 Aug55(4)233-7
5- Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography Tearney Guillermo Yabushita Hiroshi Houser Stuart Aretz H Jang Ik-kyung Schlendorf Kelly Kauffman Christopher Shishkov Milen Halpern Elkan Bouma Brett Circulation 2003107113
- Editorial Slides VP Watch January 15 2003 Volume 1 Issue 2
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Plaque Characterization Study
- Plaque Characterization
- Plaque Characterization Results
- Slide 12
- Macrophage Study
- Slide 14
- Linear NSD vs CD68
- Human Coronary Artery In Vivo
- Calcified Plaques In Vivo
- Lipid-rich Plaque In Vivo
- Thrombus In Vivo
- Conclusion
- Questions
- Slide 22
- Slide 23
-
Macrophage Study
250 microm
OCT
CD68
Low M High M
Tearney Bouma et al Circulation 2003
Linear NSD vs CD68
CD68 area gt 10 - NSD cutoff 62
R = 084P lt 00001
Tearney Bouma et al Circulation 2003
Human Coronary Artery In Vivo
P
G
L
F
G
2x
ma
i
iel eel
F
OCT IVUS
Tearney Bouma et al Circulation 2003
Calcified Plaques In Vivo
OCT IVUS
Tearney Bouma et al Circulation 2003
Lipid-rich Plaque In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Thrombus In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Conclusionbull Intracoronary OCT represents a new
technology for microscale imaging of atherosclerotic plaque
bull In exvivo studies OCT can identify macrophage intensity in plaque cap
bull Given above OCT can be an important addition to cardiovascular cat labs may completely replace IVUS catheter
Questions
I Presence of blood induces artifacts for OCT imaging knowing the time constraint in cath labs the question is how practically OCT catheter can be utilized for screening vulnerable plaques throughout total coronary arteries
Questionsbull Assuming the limited use of IVUS
(lt20) for plaque characterization in cath labs is due to cost issue would OCT with equal price be cost effective
bull With the trend towards non-invasive diagnosis and using invasive procedure only for therapy how will OCT be greeted by interventional cardiologists
ReferencesReferences
1- Fujimoto JG Boppart SA Tearney GJ Bouma BE Pitris C Brezinski ME High resolution in vivo intra-arterial imaging with optical coherence tomography Heart 1999 Aug82(2)128-33
2- Brezinski ME Tearney GJ Weissman NJ Boppart SA Bouma BE Hee MR Weyman AE Swanson EA Southern JF Fujimoto JG Assessing atherosclerotic plaque morphology comparison of optical coherence tomography and high frequency intravascular ultrasound Heart 1997 May77(5)397-403
3- Ik-Kyung Jang Brett E Bouma Dong-Heon Kang Seung-Jung Park Seong-Wook Park Ki-Bae Seung Kyu-Bo Choi Milen Shishkov Kelly Schlendorf Eugene Pomerantsev et al Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography comparison with intravascular ultrasound Pages 604-609 Journal of the American College of Cardiology 2002 Volume 39(4) 604-609
4- Tearney GJ Jang IK Kang DH Aretz HT Houser SL Brady TJ Schlendorf K Shishkov M BoumaBE Porcine coronary imaging in vivo by optical coherence tomography Acta Cardiol 2000 Aug55(4)233-7
5- Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography Tearney Guillermo Yabushita Hiroshi Houser Stuart Aretz H Jang Ik-kyung Schlendorf Kelly Kauffman Christopher Shishkov Milen Halpern Elkan Bouma Brett Circulation 2003107113
- Editorial Slides VP Watch January 15 2003 Volume 1 Issue 2
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Plaque Characterization Study
- Plaque Characterization
- Plaque Characterization Results
- Slide 12
- Macrophage Study
- Slide 14
- Linear NSD vs CD68
- Human Coronary Artery In Vivo
- Calcified Plaques In Vivo
- Lipid-rich Plaque In Vivo
- Thrombus In Vivo
- Conclusion
- Questions
- Slide 22
- Slide 23
-
Linear NSD vs CD68
CD68 area gt 10 - NSD cutoff 62
R = 084P lt 00001
Tearney Bouma et al Circulation 2003
Human Coronary Artery In Vivo
P
G
L
F
G
2x
ma
i
iel eel
F
OCT IVUS
Tearney Bouma et al Circulation 2003
Calcified Plaques In Vivo
OCT IVUS
Tearney Bouma et al Circulation 2003
Lipid-rich Plaque In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Thrombus In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Conclusionbull Intracoronary OCT represents a new
technology for microscale imaging of atherosclerotic plaque
bull In exvivo studies OCT can identify macrophage intensity in plaque cap
bull Given above OCT can be an important addition to cardiovascular cat labs may completely replace IVUS catheter
Questions
I Presence of blood induces artifacts for OCT imaging knowing the time constraint in cath labs the question is how practically OCT catheter can be utilized for screening vulnerable plaques throughout total coronary arteries
Questionsbull Assuming the limited use of IVUS
(lt20) for plaque characterization in cath labs is due to cost issue would OCT with equal price be cost effective
bull With the trend towards non-invasive diagnosis and using invasive procedure only for therapy how will OCT be greeted by interventional cardiologists
ReferencesReferences
1- Fujimoto JG Boppart SA Tearney GJ Bouma BE Pitris C Brezinski ME High resolution in vivo intra-arterial imaging with optical coherence tomography Heart 1999 Aug82(2)128-33
2- Brezinski ME Tearney GJ Weissman NJ Boppart SA Bouma BE Hee MR Weyman AE Swanson EA Southern JF Fujimoto JG Assessing atherosclerotic plaque morphology comparison of optical coherence tomography and high frequency intravascular ultrasound Heart 1997 May77(5)397-403
3- Ik-Kyung Jang Brett E Bouma Dong-Heon Kang Seung-Jung Park Seong-Wook Park Ki-Bae Seung Kyu-Bo Choi Milen Shishkov Kelly Schlendorf Eugene Pomerantsev et al Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography comparison with intravascular ultrasound Pages 604-609 Journal of the American College of Cardiology 2002 Volume 39(4) 604-609
4- Tearney GJ Jang IK Kang DH Aretz HT Houser SL Brady TJ Schlendorf K Shishkov M BoumaBE Porcine coronary imaging in vivo by optical coherence tomography Acta Cardiol 2000 Aug55(4)233-7
5- Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography Tearney Guillermo Yabushita Hiroshi Houser Stuart Aretz H Jang Ik-kyung Schlendorf Kelly Kauffman Christopher Shishkov Milen Halpern Elkan Bouma Brett Circulation 2003107113
- Editorial Slides VP Watch January 15 2003 Volume 1 Issue 2
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Plaque Characterization Study
- Plaque Characterization
- Plaque Characterization Results
- Slide 12
- Macrophage Study
- Slide 14
- Linear NSD vs CD68
- Human Coronary Artery In Vivo
- Calcified Plaques In Vivo
- Lipid-rich Plaque In Vivo
- Thrombus In Vivo
- Conclusion
- Questions
- Slide 22
- Slide 23
-
Human Coronary Artery In Vivo
P
G
L
F
G
2x
ma
i
iel eel
F
OCT IVUS
Tearney Bouma et al Circulation 2003
Calcified Plaques In Vivo
OCT IVUS
Tearney Bouma et al Circulation 2003
Lipid-rich Plaque In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Thrombus In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Conclusionbull Intracoronary OCT represents a new
technology for microscale imaging of atherosclerotic plaque
bull In exvivo studies OCT can identify macrophage intensity in plaque cap
bull Given above OCT can be an important addition to cardiovascular cat labs may completely replace IVUS catheter
Questions
I Presence of blood induces artifacts for OCT imaging knowing the time constraint in cath labs the question is how practically OCT catheter can be utilized for screening vulnerable plaques throughout total coronary arteries
Questionsbull Assuming the limited use of IVUS
(lt20) for plaque characterization in cath labs is due to cost issue would OCT with equal price be cost effective
bull With the trend towards non-invasive diagnosis and using invasive procedure only for therapy how will OCT be greeted by interventional cardiologists
ReferencesReferences
1- Fujimoto JG Boppart SA Tearney GJ Bouma BE Pitris C Brezinski ME High resolution in vivo intra-arterial imaging with optical coherence tomography Heart 1999 Aug82(2)128-33
2- Brezinski ME Tearney GJ Weissman NJ Boppart SA Bouma BE Hee MR Weyman AE Swanson EA Southern JF Fujimoto JG Assessing atherosclerotic plaque morphology comparison of optical coherence tomography and high frequency intravascular ultrasound Heart 1997 May77(5)397-403
3- Ik-Kyung Jang Brett E Bouma Dong-Heon Kang Seung-Jung Park Seong-Wook Park Ki-Bae Seung Kyu-Bo Choi Milen Shishkov Kelly Schlendorf Eugene Pomerantsev et al Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography comparison with intravascular ultrasound Pages 604-609 Journal of the American College of Cardiology 2002 Volume 39(4) 604-609
4- Tearney GJ Jang IK Kang DH Aretz HT Houser SL Brady TJ Schlendorf K Shishkov M BoumaBE Porcine coronary imaging in vivo by optical coherence tomography Acta Cardiol 2000 Aug55(4)233-7
5- Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography Tearney Guillermo Yabushita Hiroshi Houser Stuart Aretz H Jang Ik-kyung Schlendorf Kelly Kauffman Christopher Shishkov Milen Halpern Elkan Bouma Brett Circulation 2003107113
- Editorial Slides VP Watch January 15 2003 Volume 1 Issue 2
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Plaque Characterization Study
- Plaque Characterization
- Plaque Characterization Results
- Slide 12
- Macrophage Study
- Slide 14
- Linear NSD vs CD68
- Human Coronary Artery In Vivo
- Calcified Plaques In Vivo
- Lipid-rich Plaque In Vivo
- Thrombus In Vivo
- Conclusion
- Questions
- Slide 22
- Slide 23
-
Calcified Plaques In Vivo
OCT IVUS
Tearney Bouma et al Circulation 2003
Lipid-rich Plaque In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Thrombus In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Conclusionbull Intracoronary OCT represents a new
technology for microscale imaging of atherosclerotic plaque
bull In exvivo studies OCT can identify macrophage intensity in plaque cap
bull Given above OCT can be an important addition to cardiovascular cat labs may completely replace IVUS catheter
Questions
I Presence of blood induces artifacts for OCT imaging knowing the time constraint in cath labs the question is how practically OCT catheter can be utilized for screening vulnerable plaques throughout total coronary arteries
Questionsbull Assuming the limited use of IVUS
(lt20) for plaque characterization in cath labs is due to cost issue would OCT with equal price be cost effective
bull With the trend towards non-invasive diagnosis and using invasive procedure only for therapy how will OCT be greeted by interventional cardiologists
ReferencesReferences
1- Fujimoto JG Boppart SA Tearney GJ Bouma BE Pitris C Brezinski ME High resolution in vivo intra-arterial imaging with optical coherence tomography Heart 1999 Aug82(2)128-33
2- Brezinski ME Tearney GJ Weissman NJ Boppart SA Bouma BE Hee MR Weyman AE Swanson EA Southern JF Fujimoto JG Assessing atherosclerotic plaque morphology comparison of optical coherence tomography and high frequency intravascular ultrasound Heart 1997 May77(5)397-403
3- Ik-Kyung Jang Brett E Bouma Dong-Heon Kang Seung-Jung Park Seong-Wook Park Ki-Bae Seung Kyu-Bo Choi Milen Shishkov Kelly Schlendorf Eugene Pomerantsev et al Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography comparison with intravascular ultrasound Pages 604-609 Journal of the American College of Cardiology 2002 Volume 39(4) 604-609
4- Tearney GJ Jang IK Kang DH Aretz HT Houser SL Brady TJ Schlendorf K Shishkov M BoumaBE Porcine coronary imaging in vivo by optical coherence tomography Acta Cardiol 2000 Aug55(4)233-7
5- Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography Tearney Guillermo Yabushita Hiroshi Houser Stuart Aretz H Jang Ik-kyung Schlendorf Kelly Kauffman Christopher Shishkov Milen Halpern Elkan Bouma Brett Circulation 2003107113
- Editorial Slides VP Watch January 15 2003 Volume 1 Issue 2
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Plaque Characterization Study
- Plaque Characterization
- Plaque Characterization Results
- Slide 12
- Macrophage Study
- Slide 14
- Linear NSD vs CD68
- Human Coronary Artery In Vivo
- Calcified Plaques In Vivo
- Lipid-rich Plaque In Vivo
- Thrombus In Vivo
- Conclusion
- Questions
- Slide 22
- Slide 23
-
Lipid-rich Plaque In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Thrombus In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Conclusionbull Intracoronary OCT represents a new
technology for microscale imaging of atherosclerotic plaque
bull In exvivo studies OCT can identify macrophage intensity in plaque cap
bull Given above OCT can be an important addition to cardiovascular cat labs may completely replace IVUS catheter
Questions
I Presence of blood induces artifacts for OCT imaging knowing the time constraint in cath labs the question is how practically OCT catheter can be utilized for screening vulnerable plaques throughout total coronary arteries
Questionsbull Assuming the limited use of IVUS
(lt20) for plaque characterization in cath labs is due to cost issue would OCT with equal price be cost effective
bull With the trend towards non-invasive diagnosis and using invasive procedure only for therapy how will OCT be greeted by interventional cardiologists
ReferencesReferences
1- Fujimoto JG Boppart SA Tearney GJ Bouma BE Pitris C Brezinski ME High resolution in vivo intra-arterial imaging with optical coherence tomography Heart 1999 Aug82(2)128-33
2- Brezinski ME Tearney GJ Weissman NJ Boppart SA Bouma BE Hee MR Weyman AE Swanson EA Southern JF Fujimoto JG Assessing atherosclerotic plaque morphology comparison of optical coherence tomography and high frequency intravascular ultrasound Heart 1997 May77(5)397-403
3- Ik-Kyung Jang Brett E Bouma Dong-Heon Kang Seung-Jung Park Seong-Wook Park Ki-Bae Seung Kyu-Bo Choi Milen Shishkov Kelly Schlendorf Eugene Pomerantsev et al Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography comparison with intravascular ultrasound Pages 604-609 Journal of the American College of Cardiology 2002 Volume 39(4) 604-609
4- Tearney GJ Jang IK Kang DH Aretz HT Houser SL Brady TJ Schlendorf K Shishkov M BoumaBE Porcine coronary imaging in vivo by optical coherence tomography Acta Cardiol 2000 Aug55(4)233-7
5- Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography Tearney Guillermo Yabushita Hiroshi Houser Stuart Aretz H Jang Ik-kyung Schlendorf Kelly Kauffman Christopher Shishkov Milen Halpern Elkan Bouma Brett Circulation 2003107113
- Editorial Slides VP Watch January 15 2003 Volume 1 Issue 2
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Plaque Characterization Study
- Plaque Characterization
- Plaque Characterization Results
- Slide 12
- Macrophage Study
- Slide 14
- Linear NSD vs CD68
- Human Coronary Artery In Vivo
- Calcified Plaques In Vivo
- Lipid-rich Plaque In Vivo
- Thrombus In Vivo
- Conclusion
- Questions
- Slide 22
- Slide 23
-
Thrombus In VivoOCT IVUS
Tearney Bouma et al Circulation 2003
Conclusionbull Intracoronary OCT represents a new
technology for microscale imaging of atherosclerotic plaque
bull In exvivo studies OCT can identify macrophage intensity in plaque cap
bull Given above OCT can be an important addition to cardiovascular cat labs may completely replace IVUS catheter
Questions
I Presence of blood induces artifacts for OCT imaging knowing the time constraint in cath labs the question is how practically OCT catheter can be utilized for screening vulnerable plaques throughout total coronary arteries
Questionsbull Assuming the limited use of IVUS
(lt20) for plaque characterization in cath labs is due to cost issue would OCT with equal price be cost effective
bull With the trend towards non-invasive diagnosis and using invasive procedure only for therapy how will OCT be greeted by interventional cardiologists
ReferencesReferences
1- Fujimoto JG Boppart SA Tearney GJ Bouma BE Pitris C Brezinski ME High resolution in vivo intra-arterial imaging with optical coherence tomography Heart 1999 Aug82(2)128-33
2- Brezinski ME Tearney GJ Weissman NJ Boppart SA Bouma BE Hee MR Weyman AE Swanson EA Southern JF Fujimoto JG Assessing atherosclerotic plaque morphology comparison of optical coherence tomography and high frequency intravascular ultrasound Heart 1997 May77(5)397-403
3- Ik-Kyung Jang Brett E Bouma Dong-Heon Kang Seung-Jung Park Seong-Wook Park Ki-Bae Seung Kyu-Bo Choi Milen Shishkov Kelly Schlendorf Eugene Pomerantsev et al Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography comparison with intravascular ultrasound Pages 604-609 Journal of the American College of Cardiology 2002 Volume 39(4) 604-609
4- Tearney GJ Jang IK Kang DH Aretz HT Houser SL Brady TJ Schlendorf K Shishkov M BoumaBE Porcine coronary imaging in vivo by optical coherence tomography Acta Cardiol 2000 Aug55(4)233-7
5- Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography Tearney Guillermo Yabushita Hiroshi Houser Stuart Aretz H Jang Ik-kyung Schlendorf Kelly Kauffman Christopher Shishkov Milen Halpern Elkan Bouma Brett Circulation 2003107113
- Editorial Slides VP Watch January 15 2003 Volume 1 Issue 2
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Plaque Characterization Study
- Plaque Characterization
- Plaque Characterization Results
- Slide 12
- Macrophage Study
- Slide 14
- Linear NSD vs CD68
- Human Coronary Artery In Vivo
- Calcified Plaques In Vivo
- Lipid-rich Plaque In Vivo
- Thrombus In Vivo
- Conclusion
- Questions
- Slide 22
- Slide 23
-
Conclusionbull Intracoronary OCT represents a new
technology for microscale imaging of atherosclerotic plaque
bull In exvivo studies OCT can identify macrophage intensity in plaque cap
bull Given above OCT can be an important addition to cardiovascular cat labs may completely replace IVUS catheter
Questions
I Presence of blood induces artifacts for OCT imaging knowing the time constraint in cath labs the question is how practically OCT catheter can be utilized for screening vulnerable plaques throughout total coronary arteries
Questionsbull Assuming the limited use of IVUS
(lt20) for plaque characterization in cath labs is due to cost issue would OCT with equal price be cost effective
bull With the trend towards non-invasive diagnosis and using invasive procedure only for therapy how will OCT be greeted by interventional cardiologists
ReferencesReferences
1- Fujimoto JG Boppart SA Tearney GJ Bouma BE Pitris C Brezinski ME High resolution in vivo intra-arterial imaging with optical coherence tomography Heart 1999 Aug82(2)128-33
2- Brezinski ME Tearney GJ Weissman NJ Boppart SA Bouma BE Hee MR Weyman AE Swanson EA Southern JF Fujimoto JG Assessing atherosclerotic plaque morphology comparison of optical coherence tomography and high frequency intravascular ultrasound Heart 1997 May77(5)397-403
3- Ik-Kyung Jang Brett E Bouma Dong-Heon Kang Seung-Jung Park Seong-Wook Park Ki-Bae Seung Kyu-Bo Choi Milen Shishkov Kelly Schlendorf Eugene Pomerantsev et al Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography comparison with intravascular ultrasound Pages 604-609 Journal of the American College of Cardiology 2002 Volume 39(4) 604-609
4- Tearney GJ Jang IK Kang DH Aretz HT Houser SL Brady TJ Schlendorf K Shishkov M BoumaBE Porcine coronary imaging in vivo by optical coherence tomography Acta Cardiol 2000 Aug55(4)233-7
5- Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography Tearney Guillermo Yabushita Hiroshi Houser Stuart Aretz H Jang Ik-kyung Schlendorf Kelly Kauffman Christopher Shishkov Milen Halpern Elkan Bouma Brett Circulation 2003107113
- Editorial Slides VP Watch January 15 2003 Volume 1 Issue 2
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Plaque Characterization Study
- Plaque Characterization
- Plaque Characterization Results
- Slide 12
- Macrophage Study
- Slide 14
- Linear NSD vs CD68
- Human Coronary Artery In Vivo
- Calcified Plaques In Vivo
- Lipid-rich Plaque In Vivo
- Thrombus In Vivo
- Conclusion
- Questions
- Slide 22
- Slide 23
-
Questions
I Presence of blood induces artifacts for OCT imaging knowing the time constraint in cath labs the question is how practically OCT catheter can be utilized for screening vulnerable plaques throughout total coronary arteries
Questionsbull Assuming the limited use of IVUS
(lt20) for plaque characterization in cath labs is due to cost issue would OCT with equal price be cost effective
bull With the trend towards non-invasive diagnosis and using invasive procedure only for therapy how will OCT be greeted by interventional cardiologists
ReferencesReferences
1- Fujimoto JG Boppart SA Tearney GJ Bouma BE Pitris C Brezinski ME High resolution in vivo intra-arterial imaging with optical coherence tomography Heart 1999 Aug82(2)128-33
2- Brezinski ME Tearney GJ Weissman NJ Boppart SA Bouma BE Hee MR Weyman AE Swanson EA Southern JF Fujimoto JG Assessing atherosclerotic plaque morphology comparison of optical coherence tomography and high frequency intravascular ultrasound Heart 1997 May77(5)397-403
3- Ik-Kyung Jang Brett E Bouma Dong-Heon Kang Seung-Jung Park Seong-Wook Park Ki-Bae Seung Kyu-Bo Choi Milen Shishkov Kelly Schlendorf Eugene Pomerantsev et al Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography comparison with intravascular ultrasound Pages 604-609 Journal of the American College of Cardiology 2002 Volume 39(4) 604-609
4- Tearney GJ Jang IK Kang DH Aretz HT Houser SL Brady TJ Schlendorf K Shishkov M BoumaBE Porcine coronary imaging in vivo by optical coherence tomography Acta Cardiol 2000 Aug55(4)233-7
5- Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography Tearney Guillermo Yabushita Hiroshi Houser Stuart Aretz H Jang Ik-kyung Schlendorf Kelly Kauffman Christopher Shishkov Milen Halpern Elkan Bouma Brett Circulation 2003107113
- Editorial Slides VP Watch January 15 2003 Volume 1 Issue 2
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Plaque Characterization Study
- Plaque Characterization
- Plaque Characterization Results
- Slide 12
- Macrophage Study
- Slide 14
- Linear NSD vs CD68
- Human Coronary Artery In Vivo
- Calcified Plaques In Vivo
- Lipid-rich Plaque In Vivo
- Thrombus In Vivo
- Conclusion
- Questions
- Slide 22
- Slide 23
-
Questionsbull Assuming the limited use of IVUS
(lt20) for plaque characterization in cath labs is due to cost issue would OCT with equal price be cost effective
bull With the trend towards non-invasive diagnosis and using invasive procedure only for therapy how will OCT be greeted by interventional cardiologists
ReferencesReferences
1- Fujimoto JG Boppart SA Tearney GJ Bouma BE Pitris C Brezinski ME High resolution in vivo intra-arterial imaging with optical coherence tomography Heart 1999 Aug82(2)128-33
2- Brezinski ME Tearney GJ Weissman NJ Boppart SA Bouma BE Hee MR Weyman AE Swanson EA Southern JF Fujimoto JG Assessing atherosclerotic plaque morphology comparison of optical coherence tomography and high frequency intravascular ultrasound Heart 1997 May77(5)397-403
3- Ik-Kyung Jang Brett E Bouma Dong-Heon Kang Seung-Jung Park Seong-Wook Park Ki-Bae Seung Kyu-Bo Choi Milen Shishkov Kelly Schlendorf Eugene Pomerantsev et al Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography comparison with intravascular ultrasound Pages 604-609 Journal of the American College of Cardiology 2002 Volume 39(4) 604-609
4- Tearney GJ Jang IK Kang DH Aretz HT Houser SL Brady TJ Schlendorf K Shishkov M BoumaBE Porcine coronary imaging in vivo by optical coherence tomography Acta Cardiol 2000 Aug55(4)233-7
5- Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography Tearney Guillermo Yabushita Hiroshi Houser Stuart Aretz H Jang Ik-kyung Schlendorf Kelly Kauffman Christopher Shishkov Milen Halpern Elkan Bouma Brett Circulation 2003107113
- Editorial Slides VP Watch January 15 2003 Volume 1 Issue 2
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Plaque Characterization Study
- Plaque Characterization
- Plaque Characterization Results
- Slide 12
- Macrophage Study
- Slide 14
- Linear NSD vs CD68
- Human Coronary Artery In Vivo
- Calcified Plaques In Vivo
- Lipid-rich Plaque In Vivo
- Thrombus In Vivo
- Conclusion
- Questions
- Slide 22
- Slide 23
-
ReferencesReferences
1- Fujimoto JG Boppart SA Tearney GJ Bouma BE Pitris C Brezinski ME High resolution in vivo intra-arterial imaging with optical coherence tomography Heart 1999 Aug82(2)128-33
2- Brezinski ME Tearney GJ Weissman NJ Boppart SA Bouma BE Hee MR Weyman AE Swanson EA Southern JF Fujimoto JG Assessing atherosclerotic plaque morphology comparison of optical coherence tomography and high frequency intravascular ultrasound Heart 1997 May77(5)397-403
3- Ik-Kyung Jang Brett E Bouma Dong-Heon Kang Seung-Jung Park Seong-Wook Park Ki-Bae Seung Kyu-Bo Choi Milen Shishkov Kelly Schlendorf Eugene Pomerantsev et al Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography comparison with intravascular ultrasound Pages 604-609 Journal of the American College of Cardiology 2002 Volume 39(4) 604-609
4- Tearney GJ Jang IK Kang DH Aretz HT Houser SL Brady TJ Schlendorf K Shishkov M BoumaBE Porcine coronary imaging in vivo by optical coherence tomography Acta Cardiol 2000 Aug55(4)233-7
5- Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography Tearney Guillermo Yabushita Hiroshi Houser Stuart Aretz H Jang Ik-kyung Schlendorf Kelly Kauffman Christopher Shishkov Milen Halpern Elkan Bouma Brett Circulation 2003107113
- Editorial Slides VP Watch January 15 2003 Volume 1 Issue 2
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Plaque Characterization Study
- Plaque Characterization
- Plaque Characterization Results
- Slide 12
- Macrophage Study
- Slide 14
- Linear NSD vs CD68
- Human Coronary Artery In Vivo
- Calcified Plaques In Vivo
- Lipid-rich Plaque In Vivo
- Thrombus In Vivo
- Conclusion
- Questions
- Slide 22
- Slide 23
-
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