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Correlation of Optical Coherence Tomography and Near-Infrared Spectroscopy in Detecting Lipid Core Plaques in Vivo
Aristotelis C. Papayannis, MD1,2, Eric Fuh, MD1,2, Anna Kotsia, MD, PhD1,2, George Christopoulos, MD1,2, Mohammed Alomar, MD1,
Bavana V. Rangan, BDS, MPH1, Lorenza B. Make, RCIS1, Shuaib Abdullah, MD1,2, Subhash Banerjee, MD1,2, Emmanouil S. Brilakis,
MD, PhD1,2
1. VA North Texas Healthcare System, Dallas, Texas, USA
2. University of Texas Southwestern Medical Center, Dallas, Texas, USA
Disclosures:
Dr. Banerjee: Research support from the department of Veterans Affairs (PI of the - Plaque Regression and Progenitor Cell
Mobilization with Intensive Lipid Elimination Regimen (PREMIER)) trial. Speaker honoraria from St. Jude Medical, Medtronic, and
Johnson & Johnson, Boehinger, Sanofi, Mdcare Global; research support from Boston Scientific and The Medicines Company.
Dr Brilakis: research support from the department of Veterans Affairs (PI of the Drug Eluting Stents in Saphenous Vein Graft
Angioplasty – DIVA trial and Merit grant – I01-CX000787-01) and from the National Institutes of Health (1R01HL102442-01A1);
consulting fees/speaker honoraria from St Jude Medical, Boston Scientific, Asahi, Janssen, Sanofi, Abbott Vascular and Terumo;
research support from Guerbet; spouse is an employee of Medtronic.
- The other authors have no disclosures
Abstract
Introduction: We examined the correlation of Optical Coherence Tomography (OCT) and Near-Infrared Spectroscopy (NIRS) for in
vivo detection of lipid core plaques (LCP). The correlation of NIRS and OCT for LCP detection has not been evaluated.
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Methods: Patients in whom NIRS and OCT was performed in the same vessel at the same time were identified. Each vessel was
evaluated in 2 mm segments for the presence of LCP. LCP by NIRS was defined as a yellow block on the block chemogram. LCP by
OCT was defined as area of high attenuation, low reflectivity and irregular borders with ≥60° arc. OCT images were evaluated by 2
reviewers and discrepancies were resolved by a third reviewer. The diagnostic accuracy of OCT for LCP using NIRS as the “gold
standard” was assessed.
Results: Two-hundred twenty five two mm coronary segments in 14 vessels in 13 patients were analyzed. LCP was present in 25
segments (11%) by NIRS and 75 segments (33%) by OCT. The inter- and intra-observer agreement of OCT analysis for LCP
detection was 73% (kappa=0.71) and 92%, respectively. The sensitivity and specificity of OCT for detecting LCP was 52% and 74%,
respectively when only yellow and red coronary blocks by NIRS (n=199) were analyzed. When orange and tan segments by NIRS
were considered to contain LCP, the sensitivity and specificity of OCT for LCP detection was 60% and 74%, respectively.
Conclusions: Compared to NIRS, assessment of LCP by OCT has moderate reproducibility, sensitivity and specificity for the
detection of LCP.
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