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Spectroscopic fiber optic catheter tania - aha 2001


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Spectroscopic fiber optic catheter tania - aha 2001

  1. 1. Abstract#116122: American Heart Association Scientific Sessions 2001 PROGRESS WITH THE CALIBRATION OF A 3F NEAR INFRARED SPECTROSCOPY FIBER OPTIC CATHETER FOR MONITORING THE pH OF ATHEROSCLEROTIC PLAQUE: INTRODUCING A NOVEL APPROACH FOR THE DETECTION OF VULNERABLE PLAQUE Tania Khan, Babs Soller, Mohammad Madjid, James T. Willerson, S. Ward Casscells, Morteza Naghavi Texas Heart Institute
  2. 2. Everybody has atherosclerosis, the question is who has vulnerable plaque Sudden Cardiac Death Acute MI Vulnerable Plaque(s)
  3. 3. Morphology vs. Activity Imaging Inactive and non-inflamed plaque Active and inflamed plaque Appear Similar in IVUS OCT MRI w/o CM Morphology Show Different Activity Thermography, Spectroscopy, immunoscientigraphy, MRI with targeted contrast media…
  4. 4. - Raman Spectroscopy - Near-Infrared Diffuse Reflectance Spectroscopy -Fibrousis and lipid measurement -pH and lactate measurement - Fluorescence Emission Spectroscopy - Spectroscopy with contrast media Intravascular Near Infrared Spectroscopy Intra-coronary assessment of endothelial function Intra-coronary measurement of MMPs and cytokines
  5. 5. Long-Term Objectives • Determine a empirical calibration for plaque pH using a spectroscopic fiber optic catheter system • Identify metabolic status of atherosclerotic plaques • Locate and identify vulnerable plaque with Near Infrared Spectroscopy
  6. 6. Previous Work • Near-infrared (NIR) spectroscopy has been proposed by both Lodder (UKY) and Feld (MIT) to characterize properties of vulnerable atherosclerotic plaques (VP) such as thin cap and large lipid core. • Inflamed regions of plaque are lower in pH in the atherosclerotic Watanabe rabbit; plaque pH heterogeneity demonstrated (Grascu, 1999) • Tissue pH can be measured by NIR spectroscopy in heart muscle (Soller, Zhang 1998)
  7. 7. NIR Spectroscopy • Visible to near infrared light delivered and collected by optical catheter detect changes in broad, overlapping absorption bands in proteins, lipoproteins, water, etc. • Different pathological plaques have different optical spectra H&E staining of biopsies taken of same area spectra taken. From left to right: 1. Thrombus, 2. Fibrous, and 3. Calcified. 1.0 1.5 2.0 2.5 3.0 3.5 4.0 400 500 600 700 800 900 1000 1100 wavelength absorbance(a.u.) Calcified Thrombus Fibrous
  8. 8. Hypothesis A feasible optical spectroscopic method for measuring tissue pH in ex-vivo human carotid plaques can be achieved with a localized fiber optic catheter.
  9. 9. Optical Catheter System Diagram • Optical fibers carry light to tissue • Light is reflected and/or backscattered toward fibers that return light to detector and tissue absorbance calculated • Catheter geometry and optical coupling important • Small source-detector separations: light penetrates tissue while restricting volume interrogated ~1.5 mm Light in To spectrometer wavelength Absorbance plaque interfaceEstimated penetration @ 760 nm ~ 0.65 millimeters
  10. 10. Methods • 5 human carotid endarterectomized plaques were collected and placed immediately in a humidified, 37°C controlled temperature glove-box type incubator. • A 3Fr fiber optic 360° side-viewing catheter prototype with a 50 micron spacing was used. • Optical reflectance spectra (400 – 1100 nm) were collected by a spectrometer (Foss NIRSystems). 3 Fr catheter prototype
  11. 11. Methods • Seventeen tissue pH readings were measured using micro- electrodes and correlated with matching optical reflectance spectra. • Partial Least Squares multivariate calibration techniques were used to calibrate the absorbance spectra collected by optical catheter system to electrode pH • Several wavelengths contribute to the NIR pH calibration equation using empirical algorithm and statistical analysis
  12. 12. Results • The range of the electrode pH was 6.83 to 7.54 • The R2 of the determination of tissue pH from the optical NIR calibration was 0.63. • Root Mean Squared Deviation (RMSD) was 0.14 pH units. 6.60 6.80 7.00 7.20 7.40 7.60 6.60 6.80 7.00 7.20 7.40 7.60 electrode pH NIRpH R2 = 0.63 RMSD = 0.14 pH units
  13. 13. Ongoing and Future Work • Plaque pH heterogeneity evident in physiological media • Increase study size (n≈100 pts) using physiological media to mimic in-vivo conditions • Develop other NIR-based metabolic and structural correlates to plaque vulnerability • Develop the clinically relevant coronary device • What plaque pH is considered vulnerable?
  14. 14. Conclusions This study demonstrates that plaque tissue pH can be feasibly determined with NIR spectroscopy ex vivo in a localized area. It also suggests that with further improvements, a spectroscopic fiber optic catheter meet the long-term goal of detection of vulnerable plaques based on pH.
  15. 15. Acknowledgements St. Luke’s Episcopal Hospital, Houston TX Department of Cardiology, University of Texas Houston Health Science Center Division of Vascular Biology, Texas Heart Institute Department of Surgery, University of Massachusetts Medical School This work was supported through the University of Texas Houston (DREAMSTM Project) from the U.S. Army Medical Command.