Zhao Wang1, Haibo Jia1, Jinwei Tian1, Tsunenari Soeda1, Rocco Vergallo1, Yoshiyasu Minami1, Hang Lee1, Aaron Aguirre1, James G Fujimoto1, Ik-Kyung Jang2. 1. From the Research Laboratory of Electronics, Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge (Z.W., J.G.F.); Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China (H.J., J.T.); and Cardiology Division, Massachusetts General Hospital (H.J., J.T., T.S., R.V., Y.M., A.A., I.-K.J.), MGH Biostatistics Center, Massachusetts General Hospital (H.L.), and Cardiology Division, Brigham and Women's Hospital (A.A.), Harvard Medical School, Boston, MA. 2. From the Research Laboratory of Electronics, Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge (Z.W., J.G.F.); Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China (H.J., J.T.); and Cardiology Division, Massachusetts General Hospital (H.J., J.T., T.S., R.V., Y.M., A.A., I.-K.J.), MGH Biostatistics Center, Massachusetts General Hospital (H.L.), and Cardiology Division, Brigham and Women's Hospital (A.A.), Harvard Medical School, Boston, MA. ijang@partners.org.
Abstract
BACKGROUND: Recent reports show that plaque erosion can be diagnosed in vivo using optical coherence tomography in patients with acute coronary syndrome. However, quantitative optical coherence tomographic image criteria for computer-aided diagnosis of plaque erosion have not been established. METHODS AND RESULTS: A total of 42 patients with acute coronary syndrome caused by plaque erosion were included. Plaque erosion was identified according to the previously established optical coherence tomography criteria. Both optical properties and morphological features of the focal-eroded region as well as erosion-adjacent region were analyzed using a custom-designed computer algorithm. Noneroded fibrous plaques remote from the erosion site within the same vessel were used as controls. Eroded plaques have significantly lower surface intensity (P<0.001), lower region of interest intensity (P<0.001), lower surface normalized SD (P<0.001), lower region of interest normalized SD (P<0.001), higher optical attenuation (P<0.001), larger tissue protrusion area (P<0.001), and greater surface roughness (P<0.001) when compared with control plaques. Erosion-adjacent regions also have lower region of interest normalized SD (P=0.008), higher attenuation (P<0.001), and greater surface roughness (P=0.005). Using a logistic regression model built on the quantitative features, plaque erosion can be accurately classified against intact fibrous plaques. There was low inter- and intraobserver variability associated with the algorithm-assisted quantitative assessment. CONCLUSIONS: Plaque erosion has distinctive optical properties and morphological features when compared with noneroded fibrous plaques. Quantitative image analysis may enhance diagnostic accuracy for plaque erosion in vivo.
BACKGROUND: Recent reports show that plaque erosion can be diagnosed in vivo using optical coherence tomography in patients with acute coronary syndrome. However, quantitative optical coherence tomographic image criteria for computer-aided diagnosis of plaque erosion have not been established. METHODS AND RESULTS: A total of 42 patients with acute coronary syndrome caused by plaque erosion were included. Plaque erosion was identified according to the previously established optical coherence tomography criteria. Both optical properties and morphological features of the focal-eroded region as well as erosion-adjacent region were analyzed using a custom-designed computer algorithm. Noneroded fibrous plaques remote from the erosion site within the same vessel were used as controls. Eroded plaques have significantly lower surface intensity (P<0.001), lower region of interest intensity (P<0.001), lower surface normalized SD (P<0.001), lower region of interest normalized SD (P<0.001), higher optical attenuation (P<0.001), larger tissue protrusion area (P<0.001), and greater surface roughness (P<0.001) when compared with control plaques. Erosion-adjacent regions also have lower region of interest normalized SD (P=0.008), higher attenuation (P<0.001), and greater surface roughness (P=0.005). Using a logistic regression model built on the quantitative features, plaque erosion can be accurately classified against intact fibrous plaques. There was low inter- and intraobserver variability associated with the algorithm-assisted quantitative assessment. CONCLUSIONS: Plaque erosion has distinctive optical properties and morphological features when compared with noneroded fibrous plaques. Quantitative image analysis may enhance diagnostic accuracy for plaque erosion in vivo.
Authors: Ling Zhang; Andreas Wahle; Zhi Chen; John J Lopez; Tomas Kovarnik; Milan Sonka Journal: IEEE Trans Med Imaging Date: 2017-07-11 Impact factor: 10.048