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Review of the Ability of Optical Coherence Tomography to Characterize Plaque, Including a Comparison with Intravascular Ultrasound

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Abstract

Over the last 50 years the introduction of several imaging technologies have been pivotal in reducing mortality associated with coronary artery disease. However coronary disease continues to be the leading cause of mortality in the industrialized world. Optical coherence tomography (OCT) has recently been introduced for micron scale intravascular imaging. It is analogous to ultrasound, measuring the intensity of back-reflected infrared light instead of sound. Some of the advantages of OCT include its resolution, which is higher than any currently available imaging technology and acquisition rates are near video speed. Unlike ultrasound, OCT catheters consist of simple fiber optics and contain no transducers within their frame, thereby making imaging catheters both inexpensive and small. Currently, the smallest catheters have a cross-sectional diameter of 0.014”. OCT systems are compact and portable and can be combined with a range of spectroscopic techniques. We review the application of OCT to intracoronary imaging.

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References

  1. Heart and Stroke Statistical Update (2002). American Heart Association, www.americanheart.org.

  2. E Falk (1983) ArticleTitlePlaque rupture with severe pre-existing stenosis precipitating coronary thrombosis Br Heart J 50 127–131 Occurrence Handle1:STN:280:BiyB1czhvV0%3D Occurrence Handle6882602

    CAS  PubMed  Google Scholar 

  3. MJ Davies (1996) ArticleTitleStability and instability: two faces of coronary atherosclerosis Circulation 94 2013–2020

    Google Scholar 

  4. A Farb A Burke A Tang (1996) ArticleTitleCoronary plaque erosion without rupture into a lipid core Circulation 93 1354–1363

    Google Scholar 

  5. G Pasterkamp E Falk H Woutman C Borst (2000) ArticleTitleTechniques characterizing the coronary atherosclerotic plaque: influence on clinical decision making J Am Coll Cardiol 36 13–21 Occurrence Handle10.1016/S0735-1097(00)00677-X Occurrence Handle1:STN:280:DC%2BD3czlsVOksw%3D%3D Occurrence Handle10898406

    Article  CAS  PubMed  Google Scholar 

  6. FL Ruberg JA Leopold J Loscalzo (2002) ArticleTitleAtherothrombosis: plaque instability and thrombogenesis Prog Cardiovasc Dis 44 381–394 Occurrence Handle10.1053/pcad.2002.123469 Occurrence Handle1:CAS:528:DC%2BD38Xks1Omsbw%3D Occurrence Handle12024336

    Article  CAS  PubMed  Google Scholar 

  7. HC Stary A Chandler R Dinsmore (1995) ArticleTitleA definition of advanced types of atherosclerotic lesions and a histologic classification of atherosclerosis Circulation 92 1355–1374 Occurrence Handle1:STN:280:ByqA2snnvVc%3D Occurrence Handle7648691

    CAS  PubMed  Google Scholar 

  8. HM Loree RD Kamm RG Stringfellow (1992) ArticleTitleEffects of fibrous cap thickness on peak circumferential stress in model atherosclerotic vessels Circ Res 71 850–858 Occurrence Handle1:STN:280:By2A1cnmsVQ%3D Occurrence Handle1516158

    CAS  PubMed  Google Scholar 

  9. MA ElFawal GA Berg DJ Wheatley (1987) ArticleTitleSudden coronary death in Glasgow: nature and frequency of acute coronary lesions Br Heart J 57 329–335 Occurrence Handle1:STN:280:BiiB3MzovFA%3D Occurrence Handle3580220

    CAS  PubMed  Google Scholar 

  10. RJ Frink (1994) ArticleTitleChronic ulcerated plaque: new insights into the pathogenesis of acute coronary disease J Invasive Cardiol 6 173–185 Occurrence Handle1:STN:280:BymD2crktVw%3D Occurrence Handle10155066

    CAS  PubMed  Google Scholar 

  11. G Gorge M Haude J Ge (1995) ArticleTitleIntravascular ultrasound after low and high pressure coronary stent implantation J Am Coll Cardiol 26 725–730 Occurrence Handle10.1016/0735-1097(95)00211-L Occurrence Handle1:STN:280:ByqA2s%2FlsVU%3D Occurrence Handle7642866

    Article  CAS  PubMed  Google Scholar 

  12. P Gordon M Gibson D Cohen (1993) ArticleTitleMechanisms of restenosis and redilation with coronary stents J Am Coll Cardio 21 1166–1174 Occurrence Handle1:STN:280:ByyB3M%2FisFY%3D

    CAS  Google Scholar 

  13. C Birgelen M Kutryk R Gil (1996) ArticleTitleQuantitation of the minimal luminal cross-section area after coronary stenting Am J Cardiol 78 520–525 Occurrence Handle10.1016/S0002-9149(96)00356-6 Occurrence Handle8806335

    Article  PubMed  Google Scholar 

  14. P Fitzgerald A Oshima M Hayase (2000) ArticleTitleFinal results of the can routine ultrasound influence stent expansion (CRUISE) study Circulation 102 523–530

    Google Scholar 

  15. CL De Korte EI Cespedes AFW van der Steen (1998) ArticleTitleIntravascular ultrasound elastography: assessment and imaging of elastic properties of diseased arteries and vulnerable plaque Eur J Ultrasound 7 219–224 Occurrence Handle10.1016/S0929-8266(98)00043-3 Occurrence Handle1:STN:280:DyaK1M%2FgvFaisg%3D%3D Occurrence Handle9700219

    Article  CAS  PubMed  Google Scholar 

  16. CL De Korte AF van der Steen EI Cepedes (2000) ArticleTitleCharacterization of plaque components and vulnerability with intravascular ultrasound elastography Phys Med Biol 45 1465–1475

    Google Scholar 

  17. A Van der Steen CL de Korte EI Cespedes (1998) ArticleTitleIntravascular ultrasound elastography Ultraschall Med 19 196–201 Occurrence Handle1:STN:280:DyaK1M%2FlvVyhuw%3D%3D Occurrence Handle9842682

    CAS  PubMed  Google Scholar 

  18. ME Brezinski GJ Tearney BE Bouma (1996) ArticleTitleOptical coherence tomography for optical biopsy: properties and demonstration of vascular pathology Circulation 93 1206–1213

    Google Scholar 

  19. SA Boppart BE Bouma C Pitris (1998) ArticleTitleIn vivo subcellular optical coherence tomography imaging in Xenopus laevis: implications for the early diagnosis of neoplasms Nature-Medicine 4 861–865 Occurrence Handle10.1038/nm0798-861 Occurrence Handle1:CAS:528:DyaK1cXktlKqs7o%3D Occurrence Handle9662382

    Article  CAS  PubMed  Google Scholar 

  20. GJ Tearney ME Brezinski BE Bouma (1997) ArticleTitleIn vivo endoscopic optical biopsy with optical coherence tomography Science 276 2037–2039 Occurrence Handle10.1126/science.276.5321.2037 Occurrence Handle1:CAS:528:DyaK2sXkt1amu7Y%3D Occurrence Handle9197265

    Article  CAS  PubMed  Google Scholar 

  21. Lightlab Inc (Westford, Mass.), Lightlabimaging.com.

  22. ME Brezinski GJ Tearney BE Bouma (1996) ArticleTitleImaging of coronary artery microstructure with optical coherence tomography Am J Cardiol 77 92–93 Occurrence Handle10.1016/S0002-9149(97)89143-6 Occurrence Handle1:STN:280:BymC3s3jsFI%3D Occurrence Handle8540467

    Article  CAS  PubMed  Google Scholar 

  23. ME Brezinski GJ Tearney NJ Weissman (1997) ArticleTitleAssessing atherosclerotic plaque morphology: comparison of optical coherence tomography and high frequency intravascular ultrasound Heart 77 397–404 Occurrence Handle1:STN:280:ByiA3sbosFU%3D Occurrence Handle9196405

    CAS  PubMed  Google Scholar 

  24. GJ Tearney ME Brezinski SA Boppart (1996) ArticleTitleCatheter based optical imaging of a human coronary artery Circulation 94 3013–3013

    Google Scholar 

  25. P Patwari NJ Weissman SA Boppart (2000) ArticleTitleAssessment of coronary plaque with optical coherence tomography and high frequency ultrasound Am Jo Cardiol 85 641–644 Occurrence Handle10.1016/S0002-9149(99)00825-5 Occurrence Handle1:STN:280:DC%2BD3M%2FkslClsg%3D%3D

    Article  CAS  Google Scholar 

  26. IK Jang BE Bouma DH Kang (2002) ArticleTitleVisualization of coronary atherosclerotic plaques in patients using optical coherence tomography: comparison with intravascular ultrasound J Am Coll Cardiol 39 604–609 Occurrence Handle10.1016/S0735-1097(01)01799-5 Occurrence Handle11849858

    Article  PubMed  Google Scholar 

  27. JG Fujimoto SA Boppart GJ Tearney (1999) ArticleTitleHigh resolution in vivo intraarterial imaging with optical coherence tomography Heart 82 128–133 Occurrence Handle1:STN:280:DyaK1MzktVegsQ%3D%3D Occurrence Handle10409522

    CAS  PubMed  Google Scholar 

  28. Li X, Gold H, Weissman NJ, (Submitted) Assessing stent approximation with OCT and comparison with IVUS in an in vivo rabbit model

  29. ME Brezinski K Saunders C Jesser (2001) ArticleTitleIndex matching to improve OCT imaging through blood Circulation 103 1999–2003

    Google Scholar 

  30. H Yabushita BE Bouma SL Houser (2002) ArticleTitleCharacterization of human atherosclerosis by optical coherence tomography Circulation 106 1640–1645

    Google Scholar 

  31. R van Geuns PA Wielopolski HG de Bruin (1999) ArticleTitleMagnetic resonace imaging of the coronary arteries Progress Cardiovasc Dis. 42 157–166 Occurrence Handle1:STN:280:DC%2BD3c%2FitFGrtQ%3D%3D

    CAS  Google Scholar 

  32. J Toussaint GM Lamuraglia JF Southern (1996) ArticleTitleMagnetic resonance images lipid, fibrous, calcified and thrombotic components of human atherosclerotic in vivo Circulation 94 932–938

    Google Scholar 

  33. S Worthley G Helft V Fuster (2000) ArticleTitleSerial in vivo MRI documents arterial remodeling in experimental atherosclerosis Circulation 101 586–589

    Google Scholar 

  34. M Humink KH Kuntz KE Fleischmann (1999) ArticleTitleNoninvasive imaging for the diagnosis of coronary artery disease Ann Intern Med 131 673–680 Occurrence Handle10577330

    PubMed  Google Scholar 

  35. RA O’Rouke BH Brundage VF Froelicher (2002) ArticleTitleAmerican College of Cardiology/ American Heart Association expert consensus document on EBCT for the diagnosis and prognosis of coronary artery disease J Am Coll Cardiol 36 326–340 Occurrence Handle10.1016/S0735-1097(00)00831-7

    Article  Google Scholar 

  36. W Casscells B Hathorn M David (1996) ArticleTitleThermal detection of cellular infiltrates in living atherosclerotic plaques Lancet 347 1447–1449 Occurrence Handle10.1016/S0140-6736(96)91684-0 Occurrence Handle1:STN:280:BymB38rjsFc%3D Occurrence Handle8676628

    Article  CAS  PubMed  Google Scholar 

  37. W Jaross V Neumeister P Lattke (1999) ArticleTitleDetermination of cholesterol in atherosclerotic plaques using near infrared diffuse reflection spectroscopy Atherosclerosis 147 327–337 Occurrence Handle10.1016/S0021-9150(99)00203-8 Occurrence Handle1:CAS:528:DC%2BD3cXhsFGg Occurrence Handle10559519

    Article  CAS  PubMed  Google Scholar 

  38. L Cassis RA Lodder (1993) ArticleTitleNear-IR imaging of atheromas in living arterial tissue Anal Chem 65 1247–1258 Occurrence Handle1:CAS:528:DyaK3sXhs1CnsbY%3D Occurrence Handle8503505

    CAS  PubMed  Google Scholar 

  39. P Weinmann M Jouan N Dao (1999) ArticleTitleQuantitative analysis of cholesterol and cholesteryl esters in human atherosclerotic plaques using near infrared Raman spectroscopy Atherosclerosis 140 81–88 Occurrence Handle10.1016/S0021-9150(98)00119-1

    Article  Google Scholar 

  40. AF Koop S Schroeder A Baumbach (2001) ArticleTitleNon-invasive characterization of coronary lesion morphology and composition by multislice CT: first results in comparison with intracoronary ultrasound Eur Radiol 11 1607–1611 Occurrence Handle10.1007/s003300100850 Occurrence Handle11511879

    Article  PubMed  Google Scholar 

  41. D Huang EA Swanson CP Lin (1991) ArticleTitleOptical coherence tomography Science 254 1178–1181 Occurrence Handle1:STN:280:By2D28nps1Y%3D Occurrence Handle1957169

    CAS  PubMed  Google Scholar 

  42. EA Swanson D Huang MR Hee (1992) ArticleTitleHigh speed OCT domain reflectometry Optics Letters 17 151–53 Occurrence Handle1:CAS:528:DyaK38XhtFGqtLk%3D

    CAS  Google Scholar 

  43. HA Haus (1984) Waves and Fields in Optoelectronics Prentice Hall Englewood Cliff, NJ 365–385

    Google Scholar 

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Acknowledgements

Our cardiovascular OCT work was achieved by James Fujimoto, Xingde Li, Neil Weissman, Herman Gold, Gary Tearney, Brett Bouma, Costas Pitris, Stephen Boppart, Kathleen Saunders, Christine Jesser, and James Southern. Most of the research was sponsored in part by the National Institutes of Health, the Medical Free Electron Laser Program, Office of Naval Research Contract, and the Whitaker Foundation.

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Correspondence to Mark E. Brezinski.

Appendix

Appendix

Low Coherence Interferometry and Resolution

The heart of the OCT system is a Michelson interferometer [18,41]. If the illuminating source generates light with a broad bandwidth, then the autocorrelation function or AC-coupled photon current representing the interference is then proportional to:

$$I(\Delta I)\alpha rsrrRe[F\{S(\omega)\}]cos(\omega 0\tau p)$$
(1)

where I(δl) is the intensity at the detector, rsrr is the product of the reflections off the sample and mirror, Re[F{S(ω)}] is the real component of the Fourier transform of the power spectrum of the source, ω0 is the center frequency of the source, and τp is the phase delay. The width of the spectrum and the width of the autocorrelation function (coherence length) are inversely related via the Fourier transform. Therefore, the resolution increases (shorter coherence length) with increasing source bandwidth [42].

If the source has a Gaussian spectrum with a FWHM (full width half maximum) bandwidth, δλ, and a center λ0, then the coherence length (δl) or axial resolution is

$$\Delta l=2\ln(2)/\pi)(\lambda 2\Delta\lambda)$$
(2)

The lateral resolution is determined essentially by the focusing power of the system or the lens chosen. It is described by the formula:

$$d=(2b\lambda/\pi)5$$
(3)

where d is the spot size or FWHM of the Gaussian spatial distribution, and b is the confocal parameter, which is twice the Rayleigh parameter.

System Dynamic Range

OCT has been designed near the shot noise limit by choosing a Doppler frequency (frequency shift from moving mirror) above 10 KHz to avoid 1/f noise and a proper transimpedance amplifier resistance and reference arm voltage to overcome thermal noise [42,43]. For quantum noise detection, the theoretical maximum SNR that can be achieved with OCT under the assumption of infinite linearity of electronics, no squeezing, and infinite dynamic range of the digitization electronics can be expressed:

$$SNR=10\log(\eta Ps/2h\nu NEB)$$
(4)

where ηPs/2hv is the number of electrons per unit time generated by the detector due to returning light and 1/NEB band pass filter bandwidth. The measured signal-to-noise ratio for the system ranges from 100–120 dB and was determined from the maximum signal measured off a mirror divided by the noise.

Grating Based Delay Line

It was stated that acquisition rate is determined primarily by how quickly the pathlength can be changed in the reference arm [20]. One of the most significant advances was the grating-based delay line that was developed for high speed OCT imaging. The delay line works as follows. Light from the reference arm is directed at a grating. The grating disperses the beam, resulting in a Fourier transform. The dispersed light is focused on a tilted mirror and reflects off the mirror, and is focused back on the grating where it undergoes an inverse Fourier transform. The tilt in the mirror results in a linear phase ramp. A linear phase ramp in the frequency domain results in a group delay in the time domain. By changing the angle of the mirror, different group delays are introduced that determine the acquisition rate. The groups and phase delays are controlled separately in this embodiment. The group delay is controlled by the angle of the mirror while the phase delay is controlled by the position of the center of the bandwidth on the mirror. An additional advantage is that dispersion can be controlled without a prism by altering the position of the lens relative to the grating.

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Patel, N., Stamper, D. & Brezinski, M. Review of the Ability of Optical Coherence Tomography to Characterize Plaque, Including a Comparison with Intravascular Ultrasound. Cardiovasc Intervent Radiol 28, 1–9 (2005). https://doi.org/10.1007/s00270-003-0021-1

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