OCT Compared With IVUS in a Coronary Lesion Assessment The OPUS-CLASS Study
OCT Compared With IVUS in a Coronary Lesion Assessment The OPUS-CLASS Study
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DOI：
10.1016/j.jcmg.2013.04.014
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发表时间：
2013-10-01
影响因子：
14
通讯作者：
Zhang, Shaosong
中科院分区：
文献类型：
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作者：
Kubo, Takashi;Akasaka, Takashi;Zhang, Shaosong
本研究的目的是研究频域光学相干断层扫描（FD-OCT）与定量冠状动脉造影（QCA）和血管内超声（IVUS）相比，用于冠状动脉测量的可靠性。背景FD-OCT技术具有高分辨率和管腔与血管壁之间良好的对比度，因此期望能够进行准确的管腔测量。通过血管造影、FD-OCT和IVUS对100例冠状动脉疾病患者进行了前瞻性研究。此外，使用FD-OCT和IVUS检查了5个已知管腔尺寸的体模模型（管腔直径3.08 mm;管腔面积7.45 mm（2））。结果在临床研究中，QCA测量的平均最小管腔直径明显小于FD-OCT测量的平均最小管腔直径（1.81 +/- 0.72 mm vs. 1.91 +/- 0.69 mm; p < 0.001），IVUS测量的最小管腔直径显著大于FD-OCT测量的最小管腔直径（2.09 +/- 0.60 mm对比1.91 +/- 0.69 mm; p < 0.001）。IVUS测量的最小管腔面积显著大于FD-OCT（3.68 +/- 2.06 mm（2）vs. 3.27 +/- 2.22 mm（2）; p < 0.001），尽管观察到两种成像技术之间存在显著相关性（r = 0.95，p <0.001;平均差异0.41 mm（2））。FD-OCT和IVUS均表现出良好的观察者间重现性，但IVUS测量值之间的均方根偏差约为FD-OCT测量值的两倍（0.32 mm（2）vs. 0.16 mm（2））。在体模模型中，FD-OCT的平均管腔面积等于体模模型的实际管腔面积，SD较低; IVUS高估了管腔面积，重现性低于FD-OCT（8.03 +/- 0.58 mm（2）vs. 7.45 +/- 0.17 mm（2）;结论：该前瞻性多中心研究的结果表明，FD-OCT在临床环境中提供了冠状动脉尺寸的准确和可重复的定量测量。(C)2013年美国心脏病学会基金会
OBJECTIVES The aim of this study was to investigate the reliability of frequency domain optical coherence tomography (FD-OCT) for coronary measurements compared with quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS).BACKGROUND Accurate luminal measurement is expected in FD-OCT because this technology offers high resolution and excellent contrast between lumen and vessel wall.METHODS In 5 medical centers, 100 patients with coronary artery disease were prospectively studied by using angiography, FD-OCT, and IVUS. In addition, 5 phantom models of known lumen dimensions (lumen diameter 3.08 mm; lumen area 7.45 mm(2)) were examined using FD-OCT and IVUS. Quantitative image analyses of the coronary arteries and phantom models were performed by an independent core laboratory.RESULTS In the clinical study, the mean minimum lumen diameter measured by QCA was significantly smaller than that measured by FD-OCT (1.81 +/- 0.72 mm vs. 1.91 +/- 0.69 mm; p < 0.001) and the minimum lumen diameter measured by IVUS was significantly greater than that measured by FD-OCT (2.09 +/- 0.60 mm vs. 1.91 +/- 0.69 mm; p < 0.001). The minimum lumen area measured by IVUS was significantly greater than that by FD-OCT (3.68 +/- 2.06 mm(2) vs. 3.27 +/- 2.22 mm(2); p < 0.001), although a significant correlation was observed between the 2 imaging techniques (r = 0.95, p < 0.001; mean difference 0.41 mm(2)). Both FD-OCT and IVUS exhibited good interobserver reproducibility, but the root-mean-squared deviation between measurements was approximately twice as high for the IVUS measurements compared with the FD-OCT measurements (0.32 mm(2) vs. 0.16 mm(2)). In a phantom model, the mean lumen area according to FD-OCT was equal to the actual lumen area of the phantom model, with low SD; IVUS overestimated the lumen area and was less reproducible than FD-OCT (8.03 +/- 0.58 mm(2) vs. 7.45 +/- 0.17 mm(2); p < 0.001).CONCLUSIONS The results of this prospective multicenter study demonstrate that FD-OCT provides accurate and reproducible quantitative measurements of coronary dimensions in the clinical setting. (C) 2013 by the American College of Cardiology Foundation