The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Tangential Signal Dropout Mimicking the Appearance of Lipid-rich Plaques and Macrophage Infiltration on Optical Frequency Domain Imaging

DOI: 10.4244/EIJ-D-20-00014

1. Division of Cardiology, Department of Medicine II, Kansai Medical University, Hirakata, Japan, Japan
2. Division of Surgical Pathology, Hyogo College of Medicine, Nishinomiya, Japan
3. Division of Cardiovascular Medicine and Coronary Heart Disease, Hyogo College of Medicine, Nishinomiya, Japan
Disclaimer:

As a public service to our readership, this article - peer reviewed by the Editors of EuroIntervention and external reviewers - has been published immediately upon acceptance as it was received in the last round of revision. The content of this article is the responsibility of the authors.

Please note that supplementary movies are not available online at this stage. Once a paper is published in its edited and formatted form, it will be accompanied online by any supplementary movies.

To read the full content of this article, please log in to download the PDF.

Aims: This study evaluated the optical frequency domain imaging (OFDI) artifact of tangential signal dropout (TSD), which mimics the appearance of lipid-rich plaque and macrophage (Mø) infiltration.

Methods and results: A total of 1,019 histological cross-sections from 23 autopsy hearts were matched with the corresponding OFDI images. Of those, 232 OFDI cross-sections that contained signal-poor regions with diffuse borders were classified as lipid-rich plaques. The angle θ was calculated between the OFDI beam that strikes the edge of the luminal surface of the low-intensity region and that which strikes the surface line of the low-intensity region. On histological evaluation, 182 (78%) cross-sections were classified as histologically lipidic/Mø infiltration, while the remaining 50 (22%) cross-sections as histologically non-lipidic/Mø infiltration. The angle θ was significantly smaller in the non-lipidic/Mø infiltration group than in the lipidic/Mø infiltration group (12±6° versus 37±14°, p<0.001). Receiver operating curve analysis revealed that the optimal cutoff value of the incident angle for predicting TSD was 23° with area under the curve 0.98.

Conclusions: When the OFDI imaging beam strikes the tissue at an angle q<23°, TSD artifact could occur. To eliminate image misinterpretation, our findings suggest that the OFDI catheter geometry should be considered for the accurate diagnosis of lipid-rich plaques and Mø infiltration.

Sign in to read and download the full article

Forgot your password?
No account yet? Sign up for free!
Create my pcr account

Join us for free and access thousands of articles from EuroIntervention, as well as presentations, videos, cases from PCRonline.com

Read next article
Detection of Cholesterol Crystals by Optical Coherence Tomography