Virtual histology intravascular ultrasound compared with optical coherence tomography for identification of thin-cap fibroatheroma
Takashi Kubo, Nobuo Nakamura, Yoshiki Matsuo, Yasushi Okumoto, Xiaofan Wu, So-Yeon Choi, Kenichi Komukai, Takashi Tanimoto, Yasushi Ino, Hironori Kitabata, Keizo Kimura, Masato Mizukoshi, Toshio Imanishi, Hideharu Akagi, Tadao Yamamoto, Takashi Akasaka, Takashi Kubo, Nobuo Nakamura, Yoshiki Matsuo, Yasushi Okumoto, Xiaofan Wu, So-Yeon Choi, Kenichi Komukai, Takashi Tanimoto, Yasushi Ino, Hironori Kitabata, Keizo Kimura, Masato Mizukoshi, Toshio Imanishi, Hideharu Akagi, Tadao Yamamoto, Takashi Akasaka
Abstract
Virtual histology intravascular ultrasound (VH-IVUS) allows detailed assessment of plaque composition in the clinical setting. Optical coherence tomography (OCT) has been developed as a high-resolution imaging method, which might be a promising technique to identify thin-cap fibroatheroma (TCFA) in vivo. The purpose of the present study was to evaluate the diagnostic accuracy of VH-IVUS to identify TCFA as determined by OCT.We examined 96 target lesions in patients with stable angina pectoris by using VH-IVUS and OCT. VH-IVUS derived TCFA was defined as a focal necrotic core-rich lesion without evident overlying fibrous tissue. OCT derived TCFA was defined as a plaque with a fibrous cap of < 65 µm. VH-IVUS correctly identified 16 TCFA and 67 non-TCFA but misclassified 2 TCFA and 11 non-TCFA as determined by OCT. The sensitivity, specificity, and positive and negative predictive values of VH-IVUS to identify TCFA as determined by OCT were 89%, 86%, 59%, and 97%, respectively.VH-IVUS showed an acceptable sensitivity and specificity to identify TCFA as determined by OCT. Although the positive predictive value was low reflecting a high number of false positives, the negative predictive value was notably high. Our results suggest a potential role for VH-IVUS to exclude high risk lesions for future coronary events.
Source: PubMed