C.L.I. Foundation, Rome, Italy.
IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy.
Minerva Cardiol Angiol. 2023 Jun;71(3):275-283. doi: 10.23736/S2724-5683.20.05237-8. Epub 2020 Jul 10.
In this in-vivo human study we tested the reproducibility for optical coherence tomography (OCT) assessment of lumen area (LA) and plaque components measurements, such as lipid arc extension and fibrous cap thickness (FCt).
We tested the variability of LA, lipid arc and FCt assessments in two repeated OCT pullbacks from the same diseased coronary segment matched using fiduciary anatomical landmarks. In particular, for the reliability of minimal FCt measurement we compared four different approaches based on continuous (longitudinal) or segmental (spot) individuation of smaller thickness: 1) comparison of single minimal FCt individuated alongside all plaque extension in the two pullbacks (Longitudinal (L)-spot minimal FCt value); 2) comparison of the mean FCt values of the plaque in the two pullbacks (L-plot mean FCt value); 3) comparison between the single minimal FCt value obtained in the first pullback and the single FCt obtained in the matched CS of second pullback (L-spot CS matched FCt value); 4) comparison of measurements obtained by visual selection of CS with minimal FCt s in the two pullbacks (single-spot minimal FCt value).
From the paired analyses of 20 non culprit lesions (accounting for a total of 387 matched CS), we found a suboptimal in-segment correlation for LA (Intra-Class Coefficient [ICC] 0.731), but a good in-segment correlation for lipid arc (ICC 0.963). Regarding FCt measurement, a high reproducibility was obtained applying continuous assessment; in particular, the best correlation was observed with L-spot minimal FCt value and the L-plot mean FCt (ICC 0.893 and 0.952, respectively) with small inter-pullback differences (confidence intervals less than 0.04 mm).
In this methodological study we observed a good reproducibility for quantitative plaque measurements with OCT confirming its reliability for serial assessment. In particular, longitudinal measurement in multiple adjacent frames seems to be the more accurate and reproducible approach for sequential FCt assessment.
在这项体内人体研究中，我们测试了光学相干断层扫描（OCT）评估管腔面积（LA）和斑块成分测量（如脂质弧延伸和纤维帽厚度（FCt））的重复性。
我们使用解剖学标志对同一病变冠状动脉段的两次重复 OCT 拉回进行了 LA、脂质弧和 FCt 评估的可变性测试。特别是，为了最小 FCt 测量的可靠性，我们比较了基于连续（纵向）或节段（点状）识别较小厚度的四种不同方法：1）比较两次拉回中所有斑块延伸的单个最小 FCt 个体化（纵向（L）-点状最小 FCt 值）；2）比较两次拉回中斑块的平均 FCt 值（L-图平均 FCt 值）；3）比较第一次拉回中获得的单个最小 FCt 值与第二次拉回中匹配 CS 获得的单个 FCt 值（L-点状 CS 匹配 FCt 值）；4）比较两次拉回中通过视觉选择具有最小 FCt 的 CS 获得的测量值（单点最小 FCt 值）。
对 20 个非罪犯病变（共 387 个匹配 CS）的配对分析表明，LA 的节内相关性不理想（组内相关系数 [ICC] 0.731），但脂质弧的节内相关性良好（ICC 0.963）。关于 FCt 测量，连续评估可获得高重复性；特别是，L-点状最小 FCt 值和 L-图平均 FCt 值的相关性最好（ICC 分别为 0.893 和 0.952），两次拉回之间的差异较小（置信区间小于 0.04mm）。
在这项方法学研究中，我们观察到 OCT 对定量斑块测量具有良好的可重复性，证实了其对连续评估的可靠性。特别是，在多个相邻帧中进行纵向测量似乎是评估连续 FCt 的更准确和可重复的方法。
