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      Intra-arterial catheter for simultaneous microstructural and molecular imaging in vivo

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          Abstract

          Advancing our understanding of human coronary artery disease requires new methods that can be used in patients for studying atherosclerotic plaque microstructure in relation to the molecular mechanisms that underlie its initiation, progression, and clinical complications, including myocardial infarction and sudden cardiac death. Here we report a dual-modality intra-arterial catheter for simultaneous microstructural and molecular imaging in vivo using a combination of optical frequency domain imaging (OFDI) and near-infrared fluorescence (NIRF) imaging. By providing simultaneous molecular information in the context of the surrounding tissue microstructure, this novel catheter could provide new opportunities for investigating coronary atherosclerosis and stent healing, and for identifying high-risk biological and structural coronary arterial plaques in vivo.

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          Most cited references31

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          Optical coherence tomography.

          A technique called optical coherence tomography (OCT) has been developed for noninvasive cross-sectional imaging in biological systems. OCT uses low-coherence interferometry to produce a two-dimensional image of optical scattering from internal tissue microstructures in a way that is analogous to ultrasonic pulse-echo imaging. OCT has longitudinal and lateral spatial resolutions of a few micrometers and can detect reflected signals as small as approximately 10(-10) of the incident optical power. Tomographic imaging is demonstrated in vitro in the peripapillary area of the retina and in the coronary artery, two clinically relevant examples that are representative of transparent and turbid media, respectively.
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            Optical coherence tomography

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              Characterization of human atherosclerosis by optical coherence tomography.

              High-resolution visualization of atherosclerotic plaque morphology may be essential for identifying coronary plaques that cause acute coronary events. Optical coherence tomography (OCT) is an intravascular imaging modality capable of providing cross-sectional images of tissue with a resolution of 10 micro m. To date, OCT imaging has not been investigated in sufficient detail to assess its accuracy for characterizing atherosclerotic plaques. The aim of this study was to establish objective OCT image criteria for atherosclerotic plaque characterization in vitro. OCT images of 357 (diseased) atherosclerotic arterial segments obtained at autopsy were correlated with histology. OCT image criteria for 3 types of plaque were formulated by analysis of a subset (n=50) of arterial segments. OCT images of fibrous plaques were characterized by homogeneous, signal-rich regions; fibrocalcific plaques by well-delineated, signal-poor regions with sharp borders; and lipid-rich plaques by signal-poor regions with diffuse borders. Independent validation of these criteria by 2 OCT readers for the remaining segments (n=307) demonstrated a sensitivity and specificity ranging from 71% to 79% and 97% to 98% for fibrous plaques, 95% to 96% and 97% for fibrocalcific plaques, and 90% to 94% and 90% to 92% for lipid-rich plaques, respectively (overall agreement, kappa=0.83 to 0.84). The interobserver and intraobserver reliabilities of OCT assessment were high (kappa values of 0.88 and 0.91, respectively). Objective OCT criteria are highly sensitive and specific for characterizing different types of atherosclerotic plaques. These results represent an important step in validating this new intravascular imaging modality and will provide a basis for the interpretation of intracoronary OCT images obtained from patients.
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                Author and article information

                Journal
                9502015
                8791
                Nat Med
                Nat. Med.
                Nature Medicine
                1078-8956
                1546-170X
                9 May 2011
                06 November 2011
                01 June 2012
                : 17
                : 12
                : 1680-1684
                Affiliations
                [1 ]Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, 40 Blossom Street BAR7, Boston, Massachusetts 02114, USA
                [2 ]Cardiovascular Research Center and Cardiology Division, Harvard Medical School and Massachusetts General Hospital, 185 Cambridge Street Rm 3206, Boston, Massachusetts 02114, USA
                [3 ]Cardiovascular Center, Korea University Guro Hospital, 97, Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea
                [4 ]Boston University Photonics Center, Boston, MA 02215, USA
                [5 ]Center for Systems Biology, Harvard Medical School and Massachusetts General Hospital, 185 Cambridge Street Suite 5.210, Boston, Massachusetts 02114, USA
                [6 ]Institute for Biological and Medical Imaging, Helmholtz Zentrum München und Technische Universität München, Munich, Germany
                [7 ]Harvard-MIT Health Sciences and Technology, Cambridge, MA 02138, USA
                [8 ]Department of Pathology, Harvard Medical School and Massachusetts General Hospital, Fruit Street, Boston, Massachusetts 02114, USA
                Author notes
                Correspondence : F.A.J. ( fjaffer@ 123456mgh.harvard.edu ) and G.J.T. ( gtearney@ 123456partners.org )
                [9]

                These authors contributed equally to this work.

                Article
                nihpa292018
                10.1038/nm.2555
                3233646
                22057345
                8e9a2eda-3184-4d42-942d-04eea86076a4

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                History
                Funding
                Funded by: National Heart, Lung, and Blood Institute : NHLBI
                Award ID: R01 HL108229-02 || HL
                Funded by: National Heart, Lung, and Blood Institute : NHLBI
                Award ID: R01 HL108229-01A1 || HL
                Funded by: National Heart, Lung, and Blood Institute : NHLBI
                Award ID: R01 HL093717-04 || HL
                Funded by: National Heart, Lung, and Blood Institute : NHLBI
                Award ID: R01 HL076398-06 || HL
                Categories
                Article

                Medicine
                Medicine

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