Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Symposium jang

55 views

Published on

SHAPE Society

Published in: Health & Medicine
  • Be the first to comment

  • Be the first to like this

Symposium jang

  1. 1. Optical Coherence Tomography: Optical Biopsy with a Short Photonic Needle? I.K. Jang, MD Massachusetts General Hospital Harvard Medical School The 3rd Vulnerable Plaque Symposium Atlanta, March 16, 2002
  2. 2. Optical Coherence Tomography • Optical analog of ultrasound • Cross-sectional imaging • 10 µm resolution • 2 mm penetration depth Low signal High signal
  3. 3. MGH OCT System Technical Data Optical wavelength : Image acquisition rate : Catheter: Axial Resolution : Transverse Resolution : Data storage : 1300 nm 4-8 images / sec 3.0 F 10 µm 25 µm Digital
  4. 4. Ex Vivo Study Aim Establish OCT criteria for plaque characterization Materials and Methods • 357 arterial segments from 90 cadavers – 78 Coronary; 86 Carotid; 143 Aorta • training set, n=50 validation set, n = 307 • Specimen registration • OCT imaging • Histology processing • Correlation of OCT with histology
  5. 5. Ex Vivo Study Type Number Fibrous 11 (22%) Calcific 27 (54%) Lipid pool 12 (24%) Type Number Fibrous 67 (22%) Calcific 167 (54%) Lipid pool 73 (24%) Validation Set (n = 307)Training Set (n = 50) Histologic Diagnoses
  6. 6. OCT Characteristics lp lp Homogeneous, Signal-rich Fibrous Lipid Echolucent, Diffuse Borders Echolucent, Sharp Borders Calcific 500 µm
  7. 7. Intimal Hyperplasia Low signal High signal
  8. 8. Fibrous Plaque F I M A F EEL IEL
  9. 9. lp n lp Lipid-Rich Plaque (with neovascularization)
  10. 10. Calcific Plaque C C
  11. 11. Ex Vivo Study Results SENS .87 PPV .88 SPEC .97 NPV .96 SENS .95 PPV 1.0 SPEC 1.0 NPV .95 SENS .92 PPV .81 SPEC .94 NPV .97 Accuracy Statistics Fibrous Calcific Lipid pool Interobserver κ = 0.88, Intraobserver κ = 0.91
  12. 12. Clinical Study 1 Feasibility and Safety: Pre and Post PCI
  13. 13. Pilot Human Study Aim: Test feasibility and safety of OCT in patients Methods • 10 patients (average age 59, 8M/2F) • Coronary angiogrpahy • IVUS + OCT imaging (3.2 F catheter) • PCI • Repeat IVUS + OCT Imaging
  14. 14. Fibrous Plaque
  15. 15. Fibrous Plaque
  16. 16. Lipid-rich Plaque
  17. 17. Lipid Rich Plaque g lplp f g 2x m a i iel eel f OCT IVUS
  18. 18. Fibrous Plaque with Calcium
  19. 19. Fibrous Plaque with Calcium
  20. 20. Post balloon Dissection
  21. 21. Cutting balloon
  22. 22. Stent
  23. 23. Stent
  24. 24. Stent
  25. 25. Pilot Human Study Results  No OCT related complications  Variety of pathology imaged and compared with IVUS • 10 patients with 28 plaque segments • 8 dissections • 13 stent locations  Problems • Obstruction by blood • Motion artifacts
  26. 26. Acknowledgements Massachusetts General Hospital Cardiology Division H. Yabushita, B. MacNeill, H. Lowe, M. Hayashi, S. Clarke, E. Pomerantsev, D. DeJoseph, I.K. Jang Wellman Laboratories of Photomedicine B.E. Bouma, M. Shishkov, C. Kauffman, N. Iftima, G.J. Tearney Dept. of Pathology S. Houser, H.T. Aretz CIMIT J. Muller, T. Brady, J. Rosen Guidant Corporation D. Kilpatrick, J. Ellis, R. Jones, T. Linnemeier

×