Contrast Harmonic Intravascular Ultrasound

Goertz, David E.; Frijlink, M.E.; Tempel, Dennie; Damme, Luc C.A. van; Krams, R.; Schaar, Johannes A.; Cate, Folkert J. ten; Serruys, Patrick W.; Jong, Nico de; Steen, Antonius F.W. van der

doi:10.1097/01.rli.0000229773.11715.da

Cited by 103 publications

(46 citation statements)

References 33 publications

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“…Some of these parameters may be accessible through intravascular imaging methods. [11][12][13][14][15][16][17][18][19] In addition, plaque type and morphology prior to intervention influence the long-term procedural outcome significantly. 20 Among the parameters that influence plaque vulnerability are the thickness of the fibrous cap overlying the necrotic core, inflammation, intraplaque hemorrhage, and composition.…”

Section: Introductionmentioning

confidence: 99%

Atherosclerotic tissue characterization in vivo by optical coherence tomography attenuation imaging

Soest¹,

et al. 2010

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Optical coherence tomography (OCT) is rapidly becoming the method of choice for assessing arterial wall pathology in vivo. Atherosclerotic plaques can be diagnosed with high accuracy, including measurement of the thickness of fibrous caps, enabling an assessment of the risk of rupture. While the OCT image presents morphological information in highly resolved detail, it relies on interpretation of the images by trained readers for the identification of vessel wall components and tissue type. We present a framework to enable systematic and automatic classification of atherosclerotic plaque constituents, based on the optical attenuation coefficient mu(t) of the tissue. OCT images of 65 coronary artery segments in vitro, obtained from 14 vessels harvested at autopsy, are analyzed and correlated with histology. Vessel wall components can be distinguished based on their optical properties: necrotic core and macrophage infiltration exhibit strong attenuation, mu(t)>or=10 mm(-1), while calcific and fibrous tissue have a lower mu(t) approximately 2-5mm(-1). The algorithm is successfully applied to OCT patient data, demonstrating that the analysis can be used in a clinical setting and assist diagnostics of vessel wall pathology.

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Section: Introductionmentioning

confidence: 99%

Atherosclerotic tissue characterization in vivo by optical coherence tomography attenuation imaging

Soest¹,

et al. 2010

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“…We have recently applied this technique in studies in atherosclerotic miniswine (unpublished results) and demonstrated much improvement in contrast agent detection in the arterial wall. A number of studies have reported the use of harmonic (Goertz et al 2006), and subharmonic (Goertz et al 2007) and ultraharmonic (Maresca et al 2013) IVUS imaging with custom-made IVUS catheters for contrast-specific imaging, but those devices are not commercially available. In this study, we improved the validity of the analysis by careful matching of the aortic segments based on major branch points and landmark and analysis at multiple levels within the same aortic segment.…”

Section: Study Limitationsmentioning

confidence: 99%

Nitric Oxide Pretreatment Enhances Atheroma Component Highlighting in Vivo with Intercellular Adhesion Molecule-1-Targeted Echogenic Liposomes

Kee

Kim

Huang

et al. 2014

Ultrasound in Medicine & Biology

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We present an ultrasound technique to detect the inflammatory changes in developing atheroma. We used contrast enhanced ultrasound imaging (CEUS) with 1) ICAM-1 targeted microbubbles, a molecule of adhesion involved in the inflammatory processes into the lesions of atheroma in New Zealand White rabbits, 2) a pre-treatment with NO-loaded microbubbles and US activation at the site of the endothelium in order to enhance the permeability of the arterial wall and the penetration of the ICAM-1 targeted microbubbles. Following this procedure, the acoustic enhancement is increased by 1.2 fold. NO-ELIP pretreatment with ultrasound activation can potentially facilitate the subsequent penetration of targeted ELIP into the arterial wall, thus allowing improved detection of inflammatory changes in developing atheroma.

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“…Unfortunately, predicting the risk for future acute cardiovascular events requires knowledge of plaque composition [7], which is not provided by conventional IVUS. Several IVUS signal processing techniques have been developed at an academic level to augment IVUS capabilities in detecting and characterizing coronary artery plaques at risk [8], [9] but failed to reach clinical practice so far.…”

Section: Introductionmentioning

confidence: 99%

“…Significant academic innovations such as IVUS flow [11], [12], IVUS palpography [8], [13], harmonic IVUS [14], [15] and contrast-enhanced IVUS [9], [16] were to date not taken up by industry. Furthermore, IVUS remains a niche technology, whose clinical practice did not vastly expand nor disappear.…”

Section: Introductionmentioning

confidence: 99%

Mapping Intravascular Ultrasound Controversies in Interventional Cardiology Practice

Maresca

Adams

Maresca³

et al. 2014

PLoS ONE

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Intravascular ultrasound is a catheter-based imaging modality that was developed to investigate the condition of coronary arteries and assess the vulnerability of coronary atherosclerotic plaques in particular. Since its introduction in the clinic 20 years ago, use of intravascular ultrasound innovation has been relatively limited. Intravascular ultrasound remains a niche technology; its clinical practice did not vastly expand, except in Japan, where intravascular ultrasound is an appraised tool for guiding percutaneous coronary interventions. In this qualitative research study, we follow scholarship on the sociology of innovation in exploring both the current adoption practices and perspectives on the future of intravascular ultrasound. We conducted a survey of biomedical experts with experience in the technology, the practice, and the commercialization of intravascular ultrasound. The collected information enabled us to map intravascular ultrasound controversies as well as to outline the dynamics of the international network of experts that generates intravascular ultrasound innovations and uses intravascular ultrasound technologies. While the technology is praised for its capacity to measure coronary atherosclerotic plaque morphology and is steadily used in clinical research, the lack of demonstrated benefits of intravascular ultrasound guided coronary interventions emerges as the strongest factor that prevents its expansion. Furthermore, most of the controversies identified were external to intravascular ultrasound technology itself, meaning that decision making at the industrial, financial and regulatory levels are likely to determine the future of intravascular ultrasound. In light of opinions from the responding experts', a wider adoption of intravascular ultrasound as a stand-alone imaging modality seems rather uncertain, but the appeal for this technology may be renewed by improving image quality and through combination with complementary imaging modalities.

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Contrast Harmonic Intravascular Ultrasound

Abstract: These results indicate the feasibility of contrast harmonic intravascular ultrasound as a new technique for vasa vasorum imaging.

Cited by 103 publications

References 33 publications

Atherosclerotic tissue characterization in vivo by optical coherence tomography attenuation imaging

Atherosclerotic tissue characterization in vivo by optical coherence tomography attenuation imaging

Nitric Oxide Pretreatment Enhances Atheroma Component Highlighting in Vivo with Intercellular Adhesion Molecule-1-Targeted Echogenic Liposomes

Mapping Intravascular Ultrasound Controversies in Interventional Cardiology Practice

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