Luca Di Vito1, Manuela Agozzino2, Valeria Marco3, Andrea Ricciardi3, Monica Concardi2, Enrico Romagnoli3, Laura Gatto1, Giordano Calogero2, Luigi Tavazzi4, Eloisa Arbustini2, Francesco Prati5. 1. Interventional Cardiology Unit, San Giovanni Addolorata Hospital, Via dell'Amba Aradam 8, 00184 Rome, Italy CLI Foundation, Rome, Italy. 2. Centre for Inherited Cardiovascular Diseases, Policlinico San Matteo, Pavia, Italy. 3. CLI Foundation, Rome, Italy. 4. GVM Care and Research, Maria Cecilia Hospital, Ettore Sansavini Health Science Foundation, Cotignola, Italy. 5. Interventional Cardiology Unit, San Giovanni Addolorata Hospital, Via dell'Amba Aradam 8, 00184 Rome, Italy CLI Foundation, Rome, Italy fprati@hsangiovanni.roma.it.
Abstract
AIMS: Vulnerable plaques are characterized by a high macrophage content. We investigated the optical coherence tomography (OCT) capability of identifying coronary plaque macrophage presence using tissue property indexes. METHODS AND RESULTS: Fifteen epicardial coronary arteries were imaged by OCT and subsequently analysed by histology. Correlating OCT-histological sections were identified and regions of interest (ROIs) were selected on both atherosclerotic plaques and normal appearing vessel tracts. OCT-derived tissue property indexes named normalized standard deviation (NSD), signal attenuation, and granulometry index were applied on ROIs to identify inflamed ROIs defined as a macrophage percentage >10 by histology. Forty-three paired samples (OCT frame and histology section) were considered suitable as ROIs for analysis. Eleven out of 43 ROIs were considered inflamed and the remaining 32 ROIs were non-inflamed on the basis of histological count of macrophage percentage. All OCT-derived tissue property indexes were positively correlated with macrophage percentage (P = 0.0001 for all). Receiver operating characteristic curve analysis showed that NSD, granulometry index, and signal attenuation had a significant area under the curve (area = 0.906, 0.804, and 0.793, respectively). A two-step algorithm requiring to first apply NSD with a cut-off value of 0.0570 followed by granulometry index was able to identify an inflamed ROI with a sensitivity of 100% and a specificity of 96.8%. CONCLUSION: OCT was able to identify and quantify macrophage presence in coronary artery specimens using tissue property indexes. NSD and granulometry index showed the highest accuracy in identifying a significant plaque inflammation, especially if used together in a two-step algorithm. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Vulnerable plaques are characterized by a high macrophage content. We investigated the optical coherence tomography (OCT) capability of identifying coronary plaque macrophage presence using tissue property indexes. METHODS AND RESULTS: Fifteen epicardial coronary arteries were imaged by OCT and subsequently analysed by histology. Correlating OCT-histological sections were identified and regions of interest (ROIs) were selected on both atherosclerotic plaques and normal appearing vessel tracts. OCT-derived tissue property indexes named normalized standard deviation (NSD), signal attenuation, and granulometry index were applied on ROIs to identify inflamed ROIs defined as a macrophage percentage >10 by histology. Forty-three paired samples (OCT frame and histology section) were considered suitable as ROIs for analysis. Eleven out of 43 ROIs were considered inflamed and the remaining 32 ROIs were non-inflamed on the basis of histological count of macrophage percentage. All OCT-derived tissue property indexes were positively correlated with macrophage percentage (P = 0.0001 for all). Receiver operating characteristic curve analysis showed that NSD, granulometry index, and signal attenuation had a significant area under the curve (area = 0.906, 0.804, and 0.793, respectively). A two-step algorithm requiring to first apply NSD with a cut-off value of 0.0570 followed by granulometry index was able to identify an inflamed ROI with a sensitivity of 100% and a specificity of 96.8%. CONCLUSION: OCT was able to identify and quantify macrophage presence in coronary artery specimens using tissue property indexes. NSD and granulometry index showed the highest accuracy in identifying a significant plaque inflammation, especially if used together in a two-step algorithm. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Jose J Rico-Jimenez; Daniel U Campos-Delgado; L Maximillan Buja; Deborah Vela; Javier A Jo Journal: Atherosclerosis Date: 2019-09-28 Impact factor: 5.162
Authors: Alberto Boi; Ankush D Jamthikar; Luca Saba; Deep Gupta; Aditya Sharma; Bruno Loi; John R Laird; Narendra N Khanna; Jasjit S Suri Journal: Curr Atheroscler Rep Date: 2018-05-21 Impact factor: 5.113