A Post-market, Multi-vessel Evaluation of the Imaging of Peripheral Arteries for Diagnostic PurposeS Comparing Optical Coherence TomogrAphy and INtravascular Ultrasound Imaging (SCAN)

Vascular Disease ◽

Treatment Strategy ◽

Imaging Systems ◽

Imaging Modalities ◽

Optical Coherence ◽

Luminal Diameter ◽

The Mean ◽

Abstract Background: Intravascular imaging plays an important part in diagnosis of vascular conditions and providing insight for treatment strategy. Two main imaging modalities are intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The objective of this study was to prove non-inferiority of OCT imaging to IVUS images in matched segments of peripheral vessels in patients with suspected peripheral vascular disease. Methods: The SCAN study was a prospective, non-inferiority clinical study of matched IVUS and OCT images collected along defined segments of peripheral vessels from twelve subjects (mean age 68 10.3 years; 10 men) displaying symptoms of vascular disease. Luminal diameters were measured by both imaging systems at the distal, middle, and proximal points of the defined segments. Three blinded interventional radiologists evaluated the quality of both imaging modalities in identifying lMann-Whitney-Wilcoxon testing. Intrareader reproducibility was calculated by intraclass correlation (ICC) analysis. Results: The mean scoringof plaque, calcification, and vascular stent struts by the three readers was significant better in terms of image quality for OCT than IVUS (p<0.001, p=0.001, p=0.004, respectively). The mean scores of vessel wall component visibility and artifacts generated by the two imaging systems were not significantly different (p=0.19, p=0.07, respectively). Mean vessel luminal diameter and area at three specific locations within the vessels were not significantly different between the two imaging modalities. No patient injury, adverse effect or device malfunction were noted during thestudy. Conclusions: Imaging byOCT provides the physician with better visualization of some vessel and plaque chacteristics, but both IVUS and OCT imaging are safe and effective methods of examining peripheral vessels in order to perform diagnostic assessment of peripheral vessels and provide information necessary for the treatment strategy of peripheral artery disease.

A Post-market, Multi-vessel Evaluation of the Imaging of Peripheral Arteries for Diagnostic Purposes Comparing Optical Coherence Tomography and Intravascular Ultrasound Imaging (SCAN)

10.21203/rs.2.13874/v1 ◽

2019 ◽

Author(s):

Edward Pavillard ◽

Luke Sewell

Keyword(s):

Treatment Strategy ◽

Intraclass Correlation ◽

Imaging Systems ◽

Imaging Modalities ◽

Optical Coherence ◽

Luminal Diameter ◽

The Mean ◽

Abstract Background: Intravascular imaging plays an important part in diagnosis of vascular conditions and providing insight for treatment strategy. Two main imaging modalities are intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The objective of this study was to prove non-inferiority of OCT imaging to IVUS images in matched segments of peripheral vessels in patients with suspected peripheral vascular disease.Methods: The SCAN study was a prospective, non-inferiority clinical study of matched IVUS and OCT images collected along defined segments of peripheral vessels from twelve subjects (mean age 68 10.3 years; 10 men) displaying symptoms of vascular disease. Luminal diameters were measured by both imaging systems at the distal, middle, and proximal points of the defined segments. Three blinded interventional radiologists evaluated the quality of both imaging modalities in identifying lMann-Whitney-Wilcoxon testing. Intrareader reproducibility was calculated by intraclass correlation (ICC) analysis. Results: The mean scoringof plaque, calcification, and vascular stent struts by the three readers was significant better in terms of image quality for OCT than IVUS (p<0.001, p=0.001, p=0.004, respectively). The mean scores of vessel wall component visibility and artifacts generated by the two imaging systems were not significantly different (p=0.19, p=0.07, respectively). Mean vessel luminal diameter and area at three specific locations within the vessels were not significantly different between the two imaging modalities. No patient injury, adverse effect or device malfunction were noted during thestudy. Conclusions: Imaging byOCT provides the physician with better visualization of some vessel and plaque chacteristics, but both IVUS and OCT imaging are safe and effective methods of examining peripheral vessels in order to perform diagnostic assessment of peripheral vessels and provide information necessary for the treatment strategy of peripheral artery disease.

Using optical coherence tomography and intravascular ultrasound imaging to quantify coronary plaque cap thickness and vulnerability: a pilot study

BioMedical Engineering OnLine ◽

10.1186/s12938-020-00832-w ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Rui Lv ◽

Akiko Maehara ◽

Mitsuaki Matsumura ◽

Liang Wang ◽

Qingyu Wang ◽

...

Keyword(s):

Coronary Plaque ◽

Mean Value ◽

Optical Coherence ◽

Plaque Vulnerability ◽

Fibrous Cap ◽

Vulnerable Plaques ◽

The Mean ◽

Thickness Measurements

Abstract Background Detecting coronary vulnerable plaques in vivo and assessing their vulnerability have been great challenges for clinicians and the research community. Intravascular ultrasound (IVUS) is commonly used in clinical practice for diagnosis and treatment decisions. However, due to IVUS limited resolution (about 150–200 µm), it is not sufficient to detect vulnerable plaques with a threshold cap thickness of 65 µm. Optical Coherence Tomography (OCT) has a resolution of 15–20 µm and can measure fibrous cap thickness more accurately. The aim of this study was to use OCT as the benchmark to obtain patient-specific coronary plaque cap thickness and evaluate the differences between OCT and IVUS fibrous cap quantifications. A cap index with integer values 0–4 was also introduced as a quantitative measure of plaque vulnerability to study plaque vulnerability. Methods Data from 10 patients (mean age: 70.4; m: 6; f: 4) with coronary heart disease who underwent IVUS, OCT, and angiography were collected at Cardiovascular Research Foundation (CRF) using approved protocol with informed consent obtained. 348 slices with lipid core and fibrous caps were selected for study. Convolutional Neural Network (CNN)-based and expert-based data segmentation were performed using established methods previously published. Cap thickness data were extracted to quantify differences between IVUS and OCT measurements. Results For the 348 slices analyzed, the mean value difference between OCT and IVUS cap thickness measurements was 1.83% (p = 0.031). However, mean value of point-to-point differences was 35.76%. Comparing minimum cap thickness for each plaque, the mean value of the 20 plaque IVUS-OCT differences was 44.46%, ranging from 2.36% to 91.15%. For cap index values assigned to the 348 slices, the disagreement between OCT and IVUS assignments was 25%. However, for the OCT cap index = 2 and 3 groups, the disagreement rates were 91% and 80%, respectively. Furthermore, the observation of cap index changes from baseline to follow-up indicated that IVUS results differed from OCT by 80%. Conclusions These preliminary results demonstrated that there were significant differences between IVUS and OCT plaque cap thickness measurements. Large-scale patient studies are needed to confirm our findings.

White Thrombosis on Optical Coherence Tomography after Rotational Atherectomy of Severely Coronary Calcified Lesions

10.21203/rs.3.rs-19367/v2 ◽

2020 ◽

Author(s):

Cheng-fu CAO ◽

Yu-liang MA ◽

Qi LI ◽

Jian LIU ◽

Hong ZHAO ◽

...

Keyword(s):

Platelet Activation ◽

Stent Implantation ◽

Rotational Atherectomy ◽

Control Group ◽

Optical Coherence ◽

Burr Size ◽

No Reflow ◽

The Mean ◽

Abstract Background: Rotational atherectomy (RA) has improved percutaneous treatment of severe coronary calcified lesions, but the "no-reflow" phenomenon remains a serious complication. Platelet activation by RA may contribute to the no-reflow, we use optical coherence tomography (OCT) to test the effect of RA on white thrombosis that could confirm platelet activation indirectly. Methods: We analyzed 53 consecutive patients with coronary angiographic severe calcified lesions. All the patients were examined by OCT. Twenty patients received RA and OCT imaging performed before and after RA and after stent implantation. The remaining patients were as a control group and OCT imaging performed before balloon dilatation and after stent implantation. Results: The patients were older and higher incidence of Diabetes mellitus in the RA group. In the RA group, the mean burr size was 1.48±0.14mm. The mean rotation speed was 152,300±4,200rpm. The mean number of rotations per patient was 5.3±2.1 times and the mean ablation time per RA was 11.3±3.2 seconds. In the control group, there was no thrombogenesis during the procedure, but in the RA group, all the target vessels had only white thrombosis on OCT after RA. The average number of white thrombus per lesion after RA was 7.23±4.4, and the average length of every white thrombus was 0.51±0.33mm. In Pearson Correlation Analysis, Thrombotic load was related with burr size (r=0.575, P=0.040) and rotation number (r=0.599, P=0.031).Conclusions: White thrombosis during RA is proved by OCT in vivo. Treating calcified lesions with RA may enhance thrombogenesis. These data suggest using a proper therapy to avoid no-reflow during RA.

Recent Advances in Vascular Imaging

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvbaha.120.313609 ◽

2020 ◽

Vol 40 (12) ◽

Author(s):

Kensuke Nishimiya ◽

Yasuharu Matsumoto ◽

Hiroaki Shimokawa

Keyword(s):

Near Infrared ◽

Ex Vivo ◽

Clinical Manifestations ◽

Vascular Imaging ◽

Imaging Modalities ◽

Optical Coherence ◽

Recent Advances

Recent advances in vascular imaging have enabled us to uncover the underlying mechanisms of vascular diseases both ex vivo and in vivo. In the past decade, efforts have been made to establish various methodologies for evaluation of atherosclerotic plaque progression and vascular inflammatory changes in addition to biomarkers and clinical manifestations. Several recent publications in Arteriosclerosis, Thrombosis, and Vascular Biology highlighted the essential roles of in vivo and ex vivo vascular imaging, including magnetic resonance image, computed tomography, positron emission tomography/scintigraphy, ultrasonography, intravascular ultrasound, and most recently, optical coherence tomography, all of which can be used in bench and clinical studies at relative ease. With new methods proposed in several landmark studies, these clinically available imaging modalities will be used in the near future. Moreover, future development of intravascular imaging modalities, such as optical coherence tomography–intravascular ultrasound, optical coherence tomography–near-infrared autofluorescence, polarized-sensitive optical coherence tomography, and micro-optical coherence tomography, are anticipated for better management of patients with cardiovascular disease. In this review article, we will overview recent advances in vascular imaging and ongoing works for future developments.

Investigations on the potential of optical coherence tomography as an imaging tool for eustachian tube

Scientific Reports ◽

10.1038/s41598-021-87637-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Xiao-Mei Sun ◽

Jia-Qi Luo ◽

Zhi-Wen Xiao ◽

Qing-Yu Gu ◽

Lin-Chan Lan ◽

...

Keyword(s):

Adverse Events ◽

Eustachian Tube ◽

Diagnostic Value ◽

Optical Coherence ◽

Imaging Tool ◽

Pharyngeal Region ◽

The Mean ◽

Oct Imaging ◽

Different Characteristics

AbstractThe purpose of this study was to explore the feasibility of eustachian tube optical coherence tomography (ET-OCT) for imaging the pharyngeal region of the eustachian tube (ET). Ten subjects with ear complaints underwent ET-OCT guided by nasal endoscopy, and ET-OCT examination was performed on both sides of each subject's ETs. The process and resulting images were analysed. Ten subjects ranging from 21 to 73 years old (45 ± 14.77) were enrolled in this study. Eighteen ET-OCT imaging examinations were completed. The mean duration of each examination was 2.80 ± 1.62 min (ranging from 2 to 7 min). There were no adverse events or complications. In some subjects, the ET-OCT images clearly presented the microstructures of the ET wall, including the lumen, mucosa, submucosa, cartilage and plica. However, in some subjects, it showed different characteristics, such as an unclear hierarchy and secretions in the lumen. ET-OCT may help to distinguish the structural composition of the ET and elucidate related pathophysiological mechanisms. It is a valuable imaging tool suited for the ET, with potential diagnostic value in determining the morphology of the lumen, intraluminal mucosa and submucosal tissue in the pharyngeal region of the ET.

Choice of Intracoronary Imaging: When to Use Intravascular Ultrasound or Optical Coherence Tomography

Interventional Cardiology Review ◽

10.15420/icr.2016.11.01.11 ◽

2016 ◽

Vol 11 (1) ◽

pp. 11

Author(s):

Sudheer Koganti ◽

◽

Tushar Kotecha ◽

...

Keyword(s):

Coronary Angiography ◽

Coronary Stenosis ◽

Coronary Intervention ◽

Vessel Diameter ◽

Drug Eluting Stent ◽

Optical Coherence ◽

Disease Extent ◽

Intracoronary Imaging

Intracoronary imaging has the capability of accurately measuring vessel and stenosis dimensions, assessing vessel integrity, characterising lesion morphology and guiding optimal percutaneous coronary intervention (PCI). Coronary angiography used to detect and assess coronary stenosis severity has limitations. The 2D nature of fluoroscopic imaging provides lumen profile only and the assessment of coronary stenosis by visual estimation is subjective and prone to error. Performing PCI based on coronary angiography alone is inadequate for determining key metrics of the vessel such as dimension, extent of disease, and plaque distribution and composition. The advent of intracoronary imaging has offset the limitations of angiography and has shifted the paradigm to allow a detailed, objective appreciation of disease extent and morphology, vessel diameter, stent size and deployment and healing after PCI. It has become an essential tool in complex PCI, including rotational atherectomy, in follow-up of novel drug-eluting stent platforms and understanding the pathophysiology of stent failure after PCI (e.g. following stent thrombosis or in-stent restenosis). In this review we look at the two currently available and commonly used intracoronary imaging tools – intravascular ultrasound and optical coherence tomography – and the merits of each.

Blood Vessel Density Measured Using Dynamic Optical Coherence Tomography is a Tool for Wound Healers

The International Journal of Lower Extremity Wounds ◽

10.1177/15347346211017334 ◽

2021 ◽

pp. 153473462110173

Author(s):

Rajgopal Mani ◽

Jon Holmes ◽

Kittipan Rerkasem ◽

Nikolaos Papanas

Keyword(s):

Blood Flow ◽

Blood Vessel ◽

Chronic Wounds ◽

Vessel Density ◽

Optical Coherence ◽

Skin Microcirculation ◽

Wound Edge ◽

Venous Ulcers ◽

Dynamic optical coherence tomography (D-OCT) is a relatively new technique that may be used to study the substructures in the retina, in the skin and its microcirculation. Furthermore, D-OCT is a validated method of imaging blood flow in skin microcirculation. The skin around venous and mixed arterio-venous ulcers was imaged and found to have tortuous vessels assumed to be angiogenic sprouts, and classified as dots, blobs, coils, clumps, lines, and curves. When these images were analyzed and measurements of vessel density were made, it was observed that the prevalence of coils and clumps in wound borders was significantly greater compared with those at wound centers. This reinforced the belief of inward growth of vessels from wound edge toward wound center which, in turn, reposed confidence in following the wound edge to study healing. D-OCT imaging permits the structure and the function of the microcirculation to be imaged, and vessel density measured. This offers a new vista of skin microcirculation and using it, to better understand angiogenesis in chronic wounds.

Feasibility and Clinical Utility of Ultra-Widefield–Navigated Swept-Source Optical Coherence Tomography Imaging

Journal of VitreoRetinal Diseases ◽

10.1177/2474126421997335 ◽

2021 ◽

pp. 247412642199733

Author(s):

Kyle D. Kovacs ◽

M. Abdallah Mahrous ◽

Luis Gonzalez ◽

Benjamin E. Botsford ◽

Tamara L. Lenis ◽

...

Keyword(s):

Clinical Utility ◽

Clinical Decision Making ◽

Imaging System ◽

Imaging Modality ◽

Case Series ◽

Subretinal Fluid ◽

Optical Coherence ◽

Swept Source ◽

Purpose: This work aims to evaluate the clinical utility and feasibility of a novel scanning laser ophthalmoscope-based navigated ultra-widefield swept-source optical coherence tomography (UWF SS-OCT) imaging system. Methods: A retrospective, single-center, consecutive case series evaluated patients between September 2019 and October 2020 with UWF SS-OCT (modified Optos P200TxE, Optos PLC) as part of routine retinal care. The logistics of image acquisition, interpretability of images captured, nature of the peripheral abnormality, and clinical utility in management decisions were recorded. Results: Eighty-two eyes from 72 patients were included. Patients were aged 59.4 ± 17.1 years (range, 8-87 years). During imaging, 4.4 series of images were obtained in 4.1 minutes, with 86.4% of the image series deemed to be diagnostic of the peripheral pathology on blinded image review. The most common pathologic findings were chorioretinal scars (18 eyes). In 31 (38%) eyes, these images were meaningful in supporting clinical decision-making with definitive findings. Diagnoses imaged included retinal detachment combined with retinoschisis, retinal hole with overlying vitreous traction and subretinal fluid, vitreous inflammation overlying a peripheral scar, Coats disease, and peripheral retinal traction in sickle cell retinopathy. Conclusions: Navigated UWF SS-OCT imaging was clinically practical and provided high-quality characterization of peripheral retinal lesions for all eyes. Images directly contributed to management plans, including laser, injection or surgical treatment, for a clinically meaningful set of patients (38%). Future studies are needed to further assess the value of this imaging modality and its role in diagnosing, monitoring, and treating peripheral lesions.

Optical Coherence Tomography of Peri-Ocular Skin Cancers: An Optical Biopsy

Ocular Oncology and Pathology ◽

10.1159/000511188 ◽

2020 ◽

pp. 1-9

Author(s):

Sabrina Bergeron ◽

Bryan Arthurs ◽

Debra-Meghan Sanft ◽

Christina Mastromonaco ◽

Miguel N. Burnier Jr.

Keyword(s):

Squamous Cell Carcinoma ◽

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Basal Cell ◽

Skin Lesions ◽

Sebaceous Carcinoma ◽

Optical Coherence ◽

Introduction: Optical coherence tomography (OCT) imaging has been used as a diagnostic tool for retinal disease for several years, and OCT apparatuses are becoming increasingly powerful. However, OCT has yet to reach its full potential in ophthalmology clinics. Alike retinal layers, it has been shown that OCT is able to generate cross-sectional images of the skin and allows visualization of skin lesions in a histopathology-like manner. Objective: We aim to validate OCT as an imaging modality for peri-ocular skin cancer. Through a series of cases, we highlight findings for 3 common eyelid malignancies: basal cell carcinoma, squamous cell carcinoma and sebaceous carcinoma. We propose an OCT image-based signature for basal cell carcinoma. Methods: This is a prospective study. Fifty-eight lesions suspicious of malignancy from 57 patients were subjected to OCT imaging prior to the surgical excision of the lesion. OCT images were analysed and scored according to previously identified OCT features. Eight representative examples are presented, highlighting the OCT patterns for each malignancy side by side to its corresponding histopathological sections. Results: Out of the 58 lesions analysed, 53 were malignant. A loss of the dermal-epidermal junction is observed in all malignant lesions. A strong link is observed between the presence of subepithelial hyporeflective nests on OCT and the diagnosis of basal cell carcinoma (present in 83% of cases). Conversely, lesions of epithelial origin such as squamous cell carcinoma are most often represented on OCT by acanthosis. Two supplementary cases, one basal cell carcinoma and one sebaceous carcinoma, are provided to illustrate how OCT imaging is a valuable tool in cases where clinical observations may be unusual. Conclusions: We provide evidence supporting the use of OCT for the evaluation of peri-ocular cancers. OCT enables visualization of the skin layers in vivo, before biopsy. Our results show that certain OCT features can contribute to include or exclude a diagnosis of basal cell carcinoma. By integrating this non-invasive imaging methodology into the routine assessment of peri-ocular skin lesions, especially in health care centres where access to specialists is limited, OCT imaging can increase clinical precision, reduce delays in patient referral and enhance patient care.

Optical coherence tomography for elucidation of flow-diversion phenomena: The concept of endothelized mural thrombus behind reversible in-stent stenosis in flow-diverters

Interventional Neuroradiology ◽

10.1177/15910199211003432 ◽

2021 ◽

pp. 159101992110034

Author(s):

Andre Monteiro ◽

Demetrius K Lopes ◽

Amin Aghaebrahim ◽

Ricardo Hanel

Keyword(s):

Intracranial Aneurysms ◽

Flow Diversion ◽

Optical Coherence ◽

Recurrence Rates ◽

Oct Imaging ◽

Intravascular Optical Coherence Tomography ◽

Stenotic Area ◽

Flow Diverters ◽

Stent Stenosis

Purpose Flow-diverters have revolutionized the endovascular treatment of intracranial aneurysms, offering a durable solution to aneurysms with high recurrence rates after conventional stent-assisted coiling. Events that occur after treatment with flow-diversion, such as in-stent stenosis (ISS) are not well understood and require further assessment. After assessing an animal model with Optical Coherence Tomography (OCT), we propose a concept that could explain the mechanism causing reversible ISS after treatment of intracranial aneurysms with flow-diverters. Methods Six Pipeline Flex embolization devices (PED-Flex), six PED with Shield technology (PED-Shield), and four Solitaire AB devices were implanted in the carotid arteries (two stents per vessel) of four pigs. Intravascular optical coherence tomography (OCT) and digital subtraction angiography (DSA) images obtained on day 21 were compared to histological specimens. Results A case of ISS in a PED-Flex device was assessed with OCT imaging. Neointima with asymmetrical topography completely covering the PED struts was observed. Histological preparations of the stenotic area demonstrated thrombus on the surface of device struts, covered by neointima. Conclusion This study provides a plausible concept for reversible ISS in flow-diverters. Based on an observation of a previous experiment, we propose that similar cases of ISS are related to thrombus presence underneath endothelization, but further experiments focused on this phenomenon are needed. Optical Coherence Tomography will be useful tool when available for clinical use.