Reproducibility of volumetric intravascular ultrasound radiofrequency-based analysis of coronary plaque composition in vivo

Abstract

Intravascular ultrasound radiofrequency (RF-IVUS) data permit the analysis of coronary plaque composition in vivo and is used as an endpoint of ongoing pharmacological intervention trials. We assessed the reproducibility of volumetric RF-IVUS analyses in mild-to-moderately diseased atherosclerotic human coronary arteries in vivo. A total of 9,212 IVUS analyses on cross-sectional IVUS frames was performed to evaluate the reproducibility of volumetric RF-IVUS measurements in 33 coronary segments with a length of 27 ± 7 mm. For vessel, lumen, and plaque + media volume the relative measurement differences (P = NS for all) were (A = intraobserver comparison, same pullback) −0.40 ± 1.0%; −0.48 ± 1.4%; −0.35 ± 1.6%, (B = intraobserver comparison, repeated pullback) −0.42 ± 1.2%; −0.52 ± 1.8%; −0.43 ± 4.5% (C = interobserver comparison, same pullback) 0.71 ± 1.8%; 0.71 ± 2.2%, and 0.89 ± 5.0%, respectively. For fibrous, fibro-lipidic, calcium, and necrotic-core volumes the relative measurement differences (P = NS for all) were (A) 0.45 ± 2.1%; −1.12 ± 4.9%; −0.84 ± 2.1%; −0.22 ± 1.8%, (B) 1.40 ± 4.1%; 1.26 ± 6.7%; 2.66 ± 7.4%; 0.85 ± 4.4%, and (C) −1.60 ± 4.9%; 3.85 ± 8.2%; 1.66 ± 7.5%, and −1.58 ± 4.7%, respectively. Of note, necrotic-core volume showed on average the lowest measurement variability. Thus, in mild-to-moderate atherosclerotic coronary artery disease the reproducibility of volumetric compositional RF-IVUS measurements from the same pullback is relatively high, but lower than the reproducibility of geometrical IVUS measurements. Measurements from repeated pullbacks and by different observers show acceptable reproducibilities; the volumetric measurement of the necrotic-core shows on average the highest reproducibility of the compositional RF-IVUS measurements

Coronary plaque imaging with 256-slice multidetector computed tomography: interobserver variability of volumetric lesion parameters with semiautomatic plaque analysis software

“…Studies have shown good reproducibility of volumetric IVUS radiofrequency-based analysis of coronary plaque composition in vivo [20]. IVUS and angioscopy studies have also indicated that reduction of lesion volume and relative content changes (e.g., early loss of yellow color by angioscopy) may both reduce plaque vulnerability in an additive manner [21].…”

The Dynamic Nature of Coronary Artery Lesion Morphology Assessed by Serial Virtual Histology Intravascular Ultrasound Tissue Characterization

“…Nair et al (7), in a histological study, reported that VH-IVUS had an 80% to 92% accuracy for identification of coronary plaque DC, NC, FF, or FT. Subsequent studies demonstrated the high reproducibility of VH-IVUS analyses (11,12). Hartmann et al (12) showed that the relative difference of volumetric VH-IVUS analysis in repeated pull-backs was Ͻ1% for NC and Ͻ3% for DC, FF, and FT.…”

Thrombus aspiration in a series of patients with stable or unstable angina pectoris and lesion-site thrombus formation

“…Intravascular ultrasound (IVUS) can analyse plaque composition and indentify calcium. 13,14 Nevertheless, as the identification of thrombus by IVUS is limited and introduction of the imaging probe can induce distal embolisation, operators may sometimes -in case of doubt -chose for direct use of an aspiration catheter. Optical coherence tomography (OCT) may be an alternative imaging technique to distinguish between thrombus and calcified lesions.…”