Abstract

JACC

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TCTAP A-050

Calcified Plaque Detected on Optical Coherence Tomography With Deep Learning and Cross-validated With Optical and Ultrasonic Signals: A Complementary Appraisal and Preamble to the Use of Combined IVUS-OCT Catheter

By Jiayue Huang, Kai Ninomiya, Shengxian Tu, Shinichiro Masuda, Jouke Dijkstra, Miao Chu, Daixin Ding, Sean O. Hynes, Neil O’Leary, William Wijns, Yoshinobu Onuma, Patrick W. Serruys

Presenter

Jiayue Huang

Authors

Jiayue Huang1, Kai Ninomiya, Shengxian Tu2, Shinichiro Masuda, Jouke Dijkstra3, Miao Chu2, Daixin Ding, Sean O. Hynes4, Neil O’Leary, William Wijns, Yoshinobu Onuma, Patrick W. Serruys

Affiliation

The Lambe Institute for Translational Medicine and Curam, National University of Ireland, Galway, Ireland1, Shanghai Jiao Tong University, China2, Leiden University Medical Center, Netherlands3, University Hospital Galway and National University of Ireland, Galway, Ireland4
View Study Report
TCTAP A-050
Imaging: Intravascular

Calcified Plaque Detected on Optical Coherence Tomography With Deep Learning and Cross-validated With Optical and Ultrasonic Signals: A Complementary Appraisal and Preamble to the Use of Combined IVUS-OCT Catheter

Jiayue Huang1, Kai Ninomiya, Shengxian Tu2, Shinichiro Masuda, Jouke Dijkstra3, Miao Chu2, Daixin Ding, Sean O. Hynes4, Neil O’Leary, William Wijns, Yoshinobu Onuma, Patrick W. Serruys

The Lambe Institute for Translational Medicine and Curam, National University of Ireland, Galway, Ireland1, Shanghai Jiao Tong University, China2, Leiden University Medical Center, Netherlands3, University Hospital Galway and National University of Ireland, Galway, Ireland4

Background

Optical coherence tomography (OCT) and intravascular ultrasound (IVUS) provide complementary assessments of plaque morphology and tissue characterization. OCT-derived optical signals, IVUS-virtual histology (VH) and echogenicity have been validated on ex vivo human specimen and allow for in-vivo identification of different type of tissues. OCT deep learning (DL) emerged as a promising tool for automated plaque characterization and was derived from annotations of experts. The findings provided by this novel DL technology have not been previously cross-validated with optical and ultrasonic signals. 

Methods

Five years after implantation of bioresorbable scaffold with radiopaque markers embedded at both ends of the device, 15 patients underwent intravascular imaging with OCT and IVUS. The endovascular radiopaque markers allow for precise co-registration of OCT and IVUS images. Calcified plaque detected by OCT DL were corroborated by/with signals derived from attenuation and backscattering of the OCT light intensity, as well as with ultrasonic radio-frequency signals (IVUS-VH), their grayscale envelopes (GS)-IVUS, and their echogenic brightness function using adventitia as reference (Figure 1). Concordant identification of calcified plaques by each modality was assessed by kappa statistics and calcium arc values compared by orthogonal linear regression.

Results

In 72 matched anatomic slices, DL detected 43 calcified plaques, of which the tissue composition was confirmed by optical properties in 41 (95%). The weighted kappa between OCT DL and GS-IVUS, IVUS-VH and echogenicity for calcified plaque detection were 0.69, 0.60 and 0.60, respectively. After having excluded artifactual optical shadowing (n=5) generated by the presence of either a guidewire or a radiopaque marker, the kappa increased to 0.77, 0.68 and 0.69, respectively, with agreements ranging between 90% to 93% (Figure 1). The calcium arc derived from OCT DL showed the following and respective correlation and agreement: 1) with the calcium arc derived from GS-IVUS (ICCa=0.81 [95% CI: 0.68-0.91], difference=1.73±15.25°); 2) IVUS-VH (ICCa=0.69 [95% CI: 0.54-0.81], difference=-5.60±21.19°) and 3) echogenicity (ICCa=0.65 [95% CI: 0.46-0.83], difference=10.28 ± 18.70°). 

Conclusion

OCT empowered by DL showed substantial agreement with optical and ultrasonic signals for detecting coronary calcification. The comprehensive assessment provided by OCT and IVUS heralds the potential diagnostic value of combined IVUS-OCT catheters.

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