Abstract

Intravascular optical coherence tomography (IVOCT) is rapidly becoming the method of choice for the in vivo investigation of coronary artery disease. While IVOCT visualizes atherosclerotic plaques with a resolution <20µm, image analysis in terms of tissue composition is currently performed by a time-consuming manual procedure based on the qualitative interpretation of image features. We illustrate an algorithm for the automated and systematic characterization of IVOCT atherosclerotic tissue. The proposed method consists in a supervised classification of image pixels according to textural features combined with the estimated value of the optical attenuation coefficient. IVOCT images of 64 plaques, from 49 in vivo IVOCT data sets, constituted the algorithm’s training and testing data sets. Validation was obtained by comparing automated analysis results to the manual assessment of atherosclerotic plaques. An overall pixel-wise accuracy of 81.5% with a classification feasibility of 76.5% and per-class accuracy of 89.5%, 72.1% and 79.5% for fibrotic, calcified and lipid-rich tissue respectively, was found. Moreover, measured optical properties were in agreement with previous results reported in literature. As such, an algorithm for automated tissue characterization was developed and validated using in vivo human data, suggesting that it can be applied to clinical IVOCT data. This might be an important step towards the integration of IVOCT in cardiovascular research and routine clinical practice.

© 2013 OSA

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2013 (2)

A. C. Papayannis, A. R. Abdel-Karim, A. Mahmood, B. V. Rangan, L. B. Makke, S. Banerjee, and E. S. Brilakis, “Association of coronary lipid core plaque with intrastent thrombus formation: a near-infrared spectroscopy and optical coherence tomography study,” Catheter. Cardiovasc. Interv.81(3), 488–493 (2013).
[CrossRef] [PubMed]

F. Imola, M. Occhipinti, G. Biondi-Zoccai, L. Di Vito, V. Ramazzotti, A. Manzoli, A. Pappalardo, A. Cremonesi, M. Albertucci, and F. Prati, “Association between proximal stent edge positioning on atherosclerotic plaques containing lipid pools and postprocedural myocardial infarction (from the CLI-POOL Study),” Am. J. Cardiol.111(4), 526–531 (2013).
[CrossRef] [PubMed]

2012 (3)

G. J. Tearney, E. Regar, T. Akasaka, T. Adriaenssens, P. Barlis, H. G. Bezerra, B. Bouma, N. Bruining, J.- Cho, S. Chowdhary, M. A. Costa, R. de Silva, J. Dijkstra, C. Di Mario, D. Dudeck, E. Falk, M. D. Feldman, P. Fitzgerald, H. Garcia, N. Gonzalo, J. F. Granada, G. Guagliumi, N. R. Holm, Y. Honda, F. Ikeno, M. Kawasaki, J. Kochman, L. Koltowski, T. Kubo, T. Kume, H. Kyono, C. C. S. Lam, G. Lamouche, D. P. Lee, M. B. Leon, A. Maehara, O. Manfrini, G. S. Mintz, K. Mizuno, M.- Morel, S. Nadkarni, H. Okura, H. Otake, A. Pietrasik, F. Prati, L. Räber, M. D. Radu, J. Rieber, M. Riga, A. Rollins, M. Rosenberg, V. Sirbu, P. W. J. C. Serruys, K. Shimada, T. Shinke, J. Shite, E. Siegel, S. Sonada, M. Suter, S. Takarada, A. Tanaka, M. Terashima, T. Troels, S. Uemura, G. J. Ughi, H. M. M. van Beusekom, A. F. W. van der Steen, G.-A. van Es, G. van Soest, R. Virmani, S. Waxman, N. J. Weissman, G. Weisz, and International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT), “Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation,” J. Am. Coll. Cardiol.59(12), 1058–1072 (2012).
[CrossRef] [PubMed]

G. J. Ughi, T. Adriaenssens, K. Onsea, P. Kayaert, C. Dubois, P. Sinnaeve, M. Coosemans, W. Desmet, and J. D’hooge, “Automatic segmentation of in-vivo intra-coronary optical coherence tomography images to assess stent strut apposition and coverage,” Int. J. Cardiovasc. Imaging28(2), 229–241 (2012).
[CrossRef] [PubMed]

G. J. Ughi, T. Adriaenssens, M. Larsson, C. Dubois, P. R. Sinnaeve, M. Coosemans, W. Desmet, and J. D’hooge, “Automatic three-dimensional registration of intravascular optical coherence tomography images,” J. Biomed. Opt.17(2), 026005 (2012).
[CrossRef] [PubMed]

2011 (2)

S. J. Kang, G. S. Mintz, D. W. Park, S. W. Lee, Y. H. Kim, C. Whan Lee, K. H. Han, J. J. Kim, S. W. Park, and S. J. Park, “Mechanisms of in-stent restenosis after drug-eluting stent implantation: intravascular ultrasound analysis,” Circ. Cardiovasc. Interv.4(1), 9–14 (2011).
[CrossRef] [PubMed]

G. van Soest, E. Regar, T. P. Goderie, N. Gonzalo, S. Koljenović, G. J. van Leenders, P. W. Serruys, and A. F. van der Steen, “Pitfalls in plaque characterization by OCT: image artifacts in native coronary arteries,” JACC Cardiovasc. Imaging4(7), 810–813 (2011).
[CrossRef] [PubMed]

2010 (3)

A. Tanaka, G. J. Tearney, and B. E. Bouma, “Challenges on the frontier of intracoronary imaging: atherosclerotic plaque macrophage measurement by optical coherence tomography,” J. Biomed. Opt.15(1), 011104 (2010).
[CrossRef] [PubMed]

G. van Soest, T. Goderie, E. Regar, S. Koljenović, G. L. van Leenders, N. Gonzalo, S. van Noorden, T. Okamura, B. E. Bouma, G. J. Tearney, J. W. Oosterhuis, P. W. Serruys, and A. F. van der Steen, “Atherosclerotic tissue characterization in vivo by optical coherence tomography attenuation imaging,” J. Biomed. Opt.15(1), 011105 (2010).
[CrossRef] [PubMed]

Z. Wang, H. Kyono, H. G. Bezerra, H. Wang, M. Gargesha, C. Alraies, C. Xu, J. M. Schmitt, D. L. Wilson, M. A. Costa, and A. M. Rollins, “Semiautomatic segmentation and quantification of calcified plaques in intracoronary optical coherence tomography images,” J. Biomed. Opt.15(6), 061711 (2010).
[CrossRef] [PubMed]

2009 (1)

J. Shotton, J. Winn, C. Rother, and A. Criminisi, “TextoonBoost for image understanding: multi-class object recognition and segmentation by jointly modeling texture, layout and contextq,” Int. J. Comput. Vis.81(1), 2–23 (2009).
[CrossRef]

2008 (3)

G. Biau, L. Devroye, and G. Lugosi, “Consistency of Random Forests and other averaging classifiers,” J. Mach. Learn. Res.9(1), 2015–2033 (2008).

C. Xu, J. M. Schmitt, S. G. Carlier, and R. Virmani, “Characterization of atherosclerosis plaques by measuring both backscattering and attenuation coefficients in optical coherence tomography,” J. Biomed. Opt.13(3), 034003 (2008).
[CrossRef] [PubMed]

R. Kawaguchi, H. Tsurugaya, H. Hoshizaki, T. Toyama, S. Oshima, and K. Taniguchi, “Impact of lesion calcification on clinical and angiographic outcome after sirolimus-eluting stent implantation in real-world patients,” Cardiovasc. Revasc. Med.9(1), 2–8 (2008).
[CrossRef] [PubMed]

2006 (7)

G. Nakazawa, A. Finn, and R. Virmani, “Morphologic predictors of drug-eluting stent thrombosis,” U.S. Cardiol.4(1), 75–76 (2006).

P. O. Gislason, J. A. Benediktsson, and J. R. Sveinsson, “Random forests for land cover classification,” Pattern Recognit. Lett.27(4), 294–300 (2006).
[CrossRef]

J. Rieber, O. Meissner, G. Babaryka, S. Reim, M. Oswald, A. Koenig, T. M. Schiele, M. Shapiro, K. Theisen, M. F. Reiser, V. Klauss, and U. Hoffmann, “Diagnostic accuracy of optical coherence tomography and intravascular ultrasound for the detection and characterization of atherosclerotic plaque composition in ex-vivo coronary specimens: a comparison with histology,” Coron. Artery Dis.17(5), 425–430 (2006).
[CrossRef] [PubMed]

O. A. Meissner, J. Rieber, G. Babaryka, M. Oswald, S. Reim, U. Siebert, T. Redel, M. Reiser, and U. Mueller-Lisse, “Intravascular optical coherence tomography: comparison with histopathology in atherosclerotic peripheral artery specimens,” J. Vasc. Interv. Radiol.17(2), 343–349 (2006).
[CrossRef] [PubMed]

T. Kume, T. Akasaka, T. Kawamoto, N. Watanabe, E. Toyota, Y. Neishi, R. Sukmawan, Y. Sadahira, and K. Yoshida, “Assessment of coronary arterial plaque by optical coherence tomography,” Am. J. Cardiol.97(8), 1172–1175 (2006).
[CrossRef] [PubMed]

M. A S. Cordeiro and J. A C. Lima, “Atherosclerotic plaque characterization by multidetector row computed tomography angiography,” J. Am. Coll. Cardiol.47(8Suppl), C40–C47 (2006).
[CrossRef] [PubMed]

Y. Lin and Y. Jeon, “Random Forests and adaptive nearest neighbours,” J. Am. Stat. Assoc.101(474), 578–590 (2006).
[CrossRef]

2005 (3)

F. J. van der Meer, D. J. Faber, D. M. B. Sassoon, M. C. Aalders, G. Pasterkamp, and T. G. van Leeuwen, “Localized measurement of optical attenuation coefficients of atherosclerotic plaque constituents by quantitative optical coherence tomography,” IEEE Trans. Med. Imaging24(10), 1369–1376 (2005).
[CrossRef] [PubMed]

F. J. van der Meer, D. J. Faber, J. Perrée, G. Pasterkamp, D. Baraznji Sassoon, and T. G. van Leeuwen, “Quantitative optical coherence tomography of arterial wall components,” Lasers Med. Sci.20(1), 45–51 (2005).
[CrossRef] [PubMed]

I. K. Jang, G. J. Tearney, B. MacNeill, M. Takano, F. Moselewski, N. Iftima, M. Shishkov, S. Houser, H. T. Aretz, E. F. Halpern, and B. E. Bouma, “In vivo characterization of coronary atherosclerotic plaque by use of optical coherence tomography,” Circulation111(12), 1551–1555 (2005).
[CrossRef] [PubMed]

2004 (3)

M. D. Abramoff, P. J. Magalhales, and S. J. Ram, “Image processing with ImageJ,” Biophotonics Int.11(7), 36–42 (2004).

A. Rosset, L. Spadola, and O. Ratib, “OsiriX: an open-source software for navigating in multidimensional DICOM images,” J. Digit. Imaging17(3), 205–216 (2004).
[CrossRef] [PubMed]

L. Thrane, M. H. Frosz, T. M. Jørgensen, A. Tycho, H. T. Yura, and P. E. Andersen, “Extraction of optical scattering parameters and attenuation compensation in optical coherence tomography images of multilayered tissue structures,” Opt. Lett.29(14), 1641–1643 (2004).
[CrossRef] [PubMed]

2003 (3)

T. G. van Leeuwen, D. J. Faber, and M. C. Aalders, “Measurement of the axial point spread function in scattering media using single-mode fiber based optical coherence tomography,” IEEE J. Sel. Top. Quantum Electron.9(2), 227–233 (2003).
[CrossRef]

K. W. Gossage, T. S. Tkaczyk, J. J. Rodriguez, and J. K. Barton, “Texture analysis of optical coherence tomography images: feasibility for tissue classification,” J. Biomed. Opt.8(3), 570–575 (2003).
[CrossRef] [PubMed]

R. Virmani, A. P. Burke, F. D. Kolodgie, and A. Farb, “Pathology of the thin-cap fibroatheroma: a type of vulnerable plaque,” J. Interv. Cardiol.16(3), 267–272 (2003).
[CrossRef] [PubMed]

2002 (4)

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1997 (1)

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1993 (1)

1988 (1)

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1980 (1)

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G. J. Tearney, E. Regar, T. Akasaka, T. Adriaenssens, P. Barlis, H. G. Bezerra, B. Bouma, N. Bruining, J.- Cho, S. Chowdhary, M. A. Costa, R. de Silva, J. Dijkstra, C. Di Mario, D. Dudeck, E. Falk, M. D. Feldman, P. Fitzgerald, H. Garcia, N. Gonzalo, J. F. Granada, G. Guagliumi, N. R. Holm, Y. Honda, F. Ikeno, M. Kawasaki, J. Kochman, L. Koltowski, T. Kubo, T. Kume, H. Kyono, C. C. S. Lam, G. Lamouche, D. P. Lee, M. B. Leon, A. Maehara, O. Manfrini, G. S. Mintz, K. Mizuno, M.- Morel, S. Nadkarni, H. Okura, H. Otake, A. Pietrasik, F. Prati, L. Räber, M. D. Radu, J. Rieber, M. Riga, A. Rollins, M. Rosenberg, V. Sirbu, P. W. J. C. Serruys, K. Shimada, T. Shinke, J. Shite, E. Siegel, S. Sonada, M. Suter, S. Takarada, A. Tanaka, M. Terashima, T. Troels, S. Uemura, G. J. Ughi, H. M. M. van Beusekom, A. F. W. van der Steen, G.-A. van Es, G. van Soest, R. Virmani, S. Waxman, N. J. Weissman, G. Weisz, and International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT), “Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation,” J. Am. Coll. Cardiol.59(12), 1058–1072 (2012).
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A. Tanaka, G. J. Tearney, and B. E. Bouma, “Challenges on the frontier of intracoronary imaging: atherosclerotic plaque macrophage measurement by optical coherence tomography,” J. Biomed. Opt.15(1), 011104 (2010).
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I. K. Jang, B. E. Bouma, D. H. Kang, S. J. Park, S. W. Park, K. B. Seung, K. B. Choi, M. Shishkov, K. Schlendorf, E. Pomerantsev, S. L. Houser, H. T. Aretz, and G. J. Tearney, “Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography: comparison with intravascular ultrasound,” J. Am. Coll. Cardiol.39(4), 604–609 (2002).
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L. Breiman, “Random Forests,” Mach. Learn.45(1), 5–32 (2001).
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Brilakis, E. S.

A. C. Papayannis, A. R. Abdel-Karim, A. Mahmood, B. V. Rangan, L. B. Makke, S. Banerjee, and E. S. Brilakis, “Association of coronary lipid core plaque with intrastent thrombus formation: a near-infrared spectroscopy and optical coherence tomography study,” Catheter. Cardiovasc. Interv.81(3), 488–493 (2013).
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G. J. Tearney, E. Regar, T. Akasaka, T. Adriaenssens, P. Barlis, H. G. Bezerra, B. Bouma, N. Bruining, J.- Cho, S. Chowdhary, M. A. Costa, R. de Silva, J. Dijkstra, C. Di Mario, D. Dudeck, E. Falk, M. D. Feldman, P. Fitzgerald, H. Garcia, N. Gonzalo, J. F. Granada, G. Guagliumi, N. R. Holm, Y. Honda, F. Ikeno, M. Kawasaki, J. Kochman, L. Koltowski, T. Kubo, T. Kume, H. Kyono, C. C. S. Lam, G. Lamouche, D. P. Lee, M. B. Leon, A. Maehara, O. Manfrini, G. S. Mintz, K. Mizuno, M.- Morel, S. Nadkarni, H. Okura, H. Otake, A. Pietrasik, F. Prati, L. Räber, M. D. Radu, J. Rieber, M. Riga, A. Rollins, M. Rosenberg, V. Sirbu, P. W. J. C. Serruys, K. Shimada, T. Shinke, J. Shite, E. Siegel, S. Sonada, M. Suter, S. Takarada, A. Tanaka, M. Terashima, T. Troels, S. Uemura, G. J. Ughi, H. M. M. van Beusekom, A. F. W. van der Steen, G.-A. van Es, G. van Soest, R. Virmani, S. Waxman, N. J. Weissman, G. Weisz, and International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT), “Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation,” J. Am. Coll. Cardiol.59(12), 1058–1072 (2012).
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C. Xu, J. M. Schmitt, S. G. Carlier, and R. Virmani, “Characterization of atherosclerosis plaques by measuring both backscattering and attenuation coefficients in optical coherence tomography,” J. Biomed. Opt.13(3), 034003 (2008).
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G. J. Tearney, E. Regar, T. Akasaka, T. Adriaenssens, P. Barlis, H. G. Bezerra, B. Bouma, N. Bruining, J.- Cho, S. Chowdhary, M. A. Costa, R. de Silva, J. Dijkstra, C. Di Mario, D. Dudeck, E. Falk, M. D. Feldman, P. Fitzgerald, H. Garcia, N. Gonzalo, J. F. Granada, G. Guagliumi, N. R. Holm, Y. Honda, F. Ikeno, M. Kawasaki, J. Kochman, L. Koltowski, T. Kubo, T. Kume, H. Kyono, C. C. S. Lam, G. Lamouche, D. P. Lee, M. B. Leon, A. Maehara, O. Manfrini, G. S. Mintz, K. Mizuno, M.- Morel, S. Nadkarni, H. Okura, H. Otake, A. Pietrasik, F. Prati, L. Räber, M. D. Radu, J. Rieber, M. Riga, A. Rollins, M. Rosenberg, V. Sirbu, P. W. J. C. Serruys, K. Shimada, T. Shinke, J. Shite, E. Siegel, S. Sonada, M. Suter, S. Takarada, A. Tanaka, M. Terashima, T. Troels, S. Uemura, G. J. Ughi, H. M. M. van Beusekom, A. F. W. van der Steen, G.-A. van Es, G. van Soest, R. Virmani, S. Waxman, N. J. Weissman, G. Weisz, and International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT), “Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation,” J. Am. Coll. Cardiol.59(12), 1058–1072 (2012).
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G. van Soest, T. Goderie, E. Regar, S. Koljenović, G. L. van Leenders, N. Gonzalo, S. van Noorden, T. Okamura, B. E. Bouma, G. J. Tearney, J. W. Oosterhuis, P. W. Serruys, and A. F. van der Steen, “Atherosclerotic tissue characterization in vivo by optical coherence tomography attenuation imaging,” J. Biomed. Opt.15(1), 011105 (2010).
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A. Tanaka, G. J. Tearney, and B. E. Bouma, “Challenges on the frontier of intracoronary imaging: atherosclerotic plaque macrophage measurement by optical coherence tomography,” J. Biomed. Opt.15(1), 011104 (2010).
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I. K. Jang, G. J. Tearney, B. MacNeill, M. Takano, F. Moselewski, N. Iftima, M. Shishkov, S. Houser, H. T. Aretz, E. F. Halpern, and B. E. Bouma, “In vivo characterization of coronary atherosclerotic plaque by use of optical coherence tomography,” Circulation111(12), 1551–1555 (2005).
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I. K. Jang, B. E. Bouma, D. H. Kang, S. J. Park, S. W. Park, K. B. Seung, K. B. Choi, M. Shishkov, K. Schlendorf, E. Pomerantsev, S. L. Houser, H. T. Aretz, and G. J. Tearney, “Visualization of coronary atherosclerotic plaques in patients using optical coherence tomography: comparison with intravascular ultrasound,” J. Am. Coll. Cardiol.39(4), 604–609 (2002).
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P. W. Serruys, H. E. Luijten, K. J. Beatt, R. Geuskens, P. J. de Feyter, M. van den Brand, J. H. Reiber, H. J. ten Katen, G. A. van Es, and P. G. Hugenholtz, “Incidence of restenosis after successful coronary angioplasty: a time-related phenomenon. A quantitative angiographic study in 342 consecutive patients at 1, 2, 3, and 4 months,” Circulation77(2), 361–371 (1988).
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G. J. Tearney, E. Regar, T. Akasaka, T. Adriaenssens, P. Barlis, H. G. Bezerra, B. Bouma, N. Bruining, J.- Cho, S. Chowdhary, M. A. Costa, R. de Silva, J. Dijkstra, C. Di Mario, D. Dudeck, E. Falk, M. D. Feldman, P. Fitzgerald, H. Garcia, N. Gonzalo, J. F. Granada, G. Guagliumi, N. R. Holm, Y. Honda, F. Ikeno, M. Kawasaki, J. Kochman, L. Koltowski, T. Kubo, T. Kume, H. Kyono, C. C. S. Lam, G. Lamouche, D. P. Lee, M. B. Leon, A. Maehara, O. Manfrini, G. S. Mintz, K. Mizuno, M.- Morel, S. Nadkarni, H. Okura, H. Otake, A. Pietrasik, F. Prati, L. Räber, M. D. Radu, J. Rieber, M. Riga, A. Rollins, M. Rosenberg, V. Sirbu, P. W. J. C. Serruys, K. Shimada, T. Shinke, J. Shite, E. Siegel, S. Sonada, M. Suter, S. Takarada, A. Tanaka, M. Terashima, T. Troels, S. Uemura, G. J. Ughi, H. M. M. van Beusekom, A. F. W. van der Steen, G.-A. van Es, G. van Soest, R. Virmani, S. Waxman, N. J. Weissman, G. Weisz, and International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT), “Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation,” J. Am. Coll. Cardiol.59(12), 1058–1072 (2012).
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Tkaczyk, T. S.

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R. Kawaguchi, H. Tsurugaya, H. Hoshizaki, T. Toyama, S. Oshima, and K. Taniguchi, “Impact of lesion calcification on clinical and angiographic outcome after sirolimus-eluting stent implantation in real-world patients,” Cardiovasc. Revasc. Med.9(1), 2–8 (2008).
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T. Kume, T. Akasaka, T. Kawamoto, N. Watanabe, E. Toyota, Y. Neishi, R. Sukmawan, Y. Sadahira, and K. Yoshida, “Assessment of coronary arterial plaque by optical coherence tomography,” Am. J. Cardiol.97(8), 1172–1175 (2006).
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G. J. Tearney, E. Regar, T. Akasaka, T. Adriaenssens, P. Barlis, H. G. Bezerra, B. Bouma, N. Bruining, J.- Cho, S. Chowdhary, M. A. Costa, R. de Silva, J. Dijkstra, C. Di Mario, D. Dudeck, E. Falk, M. D. Feldman, P. Fitzgerald, H. Garcia, N. Gonzalo, J. F. Granada, G. Guagliumi, N. R. Holm, Y. Honda, F. Ikeno, M. Kawasaki, J. Kochman, L. Koltowski, T. Kubo, T. Kume, H. Kyono, C. C. S. Lam, G. Lamouche, D. P. Lee, M. B. Leon, A. Maehara, O. Manfrini, G. S. Mintz, K. Mizuno, M.- Morel, S. Nadkarni, H. Okura, H. Otake, A. Pietrasik, F. Prati, L. Räber, M. D. Radu, J. Rieber, M. Riga, A. Rollins, M. Rosenberg, V. Sirbu, P. W. J. C. Serruys, K. Shimada, T. Shinke, J. Shite, E. Siegel, S. Sonada, M. Suter, S. Takarada, A. Tanaka, M. Terashima, T. Troels, S. Uemura, G. J. Ughi, H. M. M. van Beusekom, A. F. W. van der Steen, G.-A. van Es, G. van Soest, R. Virmani, S. Waxman, N. J. Weissman, G. Weisz, and International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT), “Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation,” J. Am. Coll. Cardiol.59(12), 1058–1072 (2012).
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R. Kawaguchi, H. Tsurugaya, H. Hoshizaki, T. Toyama, S. Oshima, and K. Taniguchi, “Impact of lesion calcification on clinical and angiographic outcome after sirolimus-eluting stent implantation in real-world patients,” Cardiovasc. Revasc. Med.9(1), 2–8 (2008).
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G. J. Tearney, E. Regar, T. Akasaka, T. Adriaenssens, P. Barlis, H. G. Bezerra, B. Bouma, N. Bruining, J.- Cho, S. Chowdhary, M. A. Costa, R. de Silva, J. Dijkstra, C. Di Mario, D. Dudeck, E. Falk, M. D. Feldman, P. Fitzgerald, H. Garcia, N. Gonzalo, J. F. Granada, G. Guagliumi, N. R. Holm, Y. Honda, F. Ikeno, M. Kawasaki, J. Kochman, L. Koltowski, T. Kubo, T. Kume, H. Kyono, C. C. S. Lam, G. Lamouche, D. P. Lee, M. B. Leon, A. Maehara, O. Manfrini, G. S. Mintz, K. Mizuno, M.- Morel, S. Nadkarni, H. Okura, H. Otake, A. Pietrasik, F. Prati, L. Räber, M. D. Radu, J. Rieber, M. Riga, A. Rollins, M. Rosenberg, V. Sirbu, P. W. J. C. Serruys, K. Shimada, T. Shinke, J. Shite, E. Siegel, S. Sonada, M. Suter, S. Takarada, A. Tanaka, M. Terashima, T. Troels, S. Uemura, G. J. Ughi, H. M. M. van Beusekom, A. F. W. van der Steen, G.-A. van Es, G. van Soest, R. Virmani, S. Waxman, N. J. Weissman, G. Weisz, and International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT), “Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation,” J. Am. Coll. Cardiol.59(12), 1058–1072 (2012).
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G. J. Tearney, E. Regar, T. Akasaka, T. Adriaenssens, P. Barlis, H. G. Bezerra, B. Bouma, N. Bruining, J.- Cho, S. Chowdhary, M. A. Costa, R. de Silva, J. Dijkstra, C. Di Mario, D. Dudeck, E. Falk, M. D. Feldman, P. Fitzgerald, H. Garcia, N. Gonzalo, J. F. Granada, G. Guagliumi, N. R. Holm, Y. Honda, F. Ikeno, M. Kawasaki, J. Kochman, L. Koltowski, T. Kubo, T. Kume, H. Kyono, C. C. S. Lam, G. Lamouche, D. P. Lee, M. B. Leon, A. Maehara, O. Manfrini, G. S. Mintz, K. Mizuno, M.- Morel, S. Nadkarni, H. Okura, H. Otake, A. Pietrasik, F. Prati, L. Räber, M. D. Radu, J. Rieber, M. Riga, A. Rollins, M. Rosenberg, V. Sirbu, P. W. J. C. Serruys, K. Shimada, T. Shinke, J. Shite, E. Siegel, S. Sonada, M. Suter, S. Takarada, A. Tanaka, M. Terashima, T. Troels, S. Uemura, G. J. Ughi, H. M. M. van Beusekom, A. F. W. van der Steen, G.-A. van Es, G. van Soest, R. Virmani, S. Waxman, N. J. Weissman, G. Weisz, and International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT), “Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation,” J. Am. Coll. Cardiol.59(12), 1058–1072 (2012).
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G. J. Ughi, T. Adriaenssens, K. Onsea, P. Kayaert, C. Dubois, P. Sinnaeve, M. Coosemans, W. Desmet, and J. D’hooge, “Automatic segmentation of in-vivo intra-coronary optical coherence tomography images to assess stent strut apposition and coverage,” Int. J. Cardiovasc. Imaging28(2), 229–241 (2012).
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G. J. Ughi, T. Adriaenssens, M. Larsson, C. Dubois, P. R. Sinnaeve, M. Coosemans, W. Desmet, and J. D’hooge, “Automatic three-dimensional registration of intravascular optical coherence tomography images,” J. Biomed. Opt.17(2), 026005 (2012).
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G. J. Tearney, E. Regar, T. Akasaka, T. Adriaenssens, P. Barlis, H. G. Bezerra, B. Bouma, N. Bruining, J.- Cho, S. Chowdhary, M. A. Costa, R. de Silva, J. Dijkstra, C. Di Mario, D. Dudeck, E. Falk, M. D. Feldman, P. Fitzgerald, H. Garcia, N. Gonzalo, J. F. Granada, G. Guagliumi, N. R. Holm, Y. Honda, F. Ikeno, M. Kawasaki, J. Kochman, L. Koltowski, T. Kubo, T. Kume, H. Kyono, C. C. S. Lam, G. Lamouche, D. P. Lee, M. B. Leon, A. Maehara, O. Manfrini, G. S. Mintz, K. Mizuno, M.- Morel, S. Nadkarni, H. Okura, H. Otake, A. Pietrasik, F. Prati, L. Räber, M. D. Radu, J. Rieber, M. Riga, A. Rollins, M. Rosenberg, V. Sirbu, P. W. J. C. Serruys, K. Shimada, T. Shinke, J. Shite, E. Siegel, S. Sonada, M. Suter, S. Takarada, A. Tanaka, M. Terashima, T. Troels, S. Uemura, G. J. Ughi, H. M. M. van Beusekom, A. F. W. van der Steen, G.-A. van Es, G. van Soest, R. Virmani, S. Waxman, N. J. Weissman, G. Weisz, and International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT), “Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation,” J. Am. Coll. Cardiol.59(12), 1058–1072 (2012).
[CrossRef] [PubMed]

van den Brand, M.

P. W. Serruys, H. E. Luijten, K. J. Beatt, R. Geuskens, P. J. de Feyter, M. van den Brand, J. H. Reiber, H. J. ten Katen, G. A. van Es, and P. G. Hugenholtz, “Incidence of restenosis after successful coronary angioplasty: a time-related phenomenon. A quantitative angiographic study in 342 consecutive patients at 1, 2, 3, and 4 months,” Circulation77(2), 361–371 (1988).
[CrossRef] [PubMed]

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F. J. van der Meer, D. J. Faber, D. M. B. Sassoon, M. C. Aalders, G. Pasterkamp, and T. G. van Leeuwen, “Localized measurement of optical attenuation coefficients of atherosclerotic plaque constituents by quantitative optical coherence tomography,” IEEE Trans. Med. Imaging24(10), 1369–1376 (2005).
[CrossRef] [PubMed]

F. J. van der Meer, D. J. Faber, J. Perrée, G. Pasterkamp, D. Baraznji Sassoon, and T. G. van Leeuwen, “Quantitative optical coherence tomography of arterial wall components,” Lasers Med. Sci.20(1), 45–51 (2005).
[CrossRef] [PubMed]

van der Steen, A. F.

G. van Soest, E. Regar, T. P. Goderie, N. Gonzalo, S. Koljenović, G. J. van Leenders, P. W. Serruys, and A. F. van der Steen, “Pitfalls in plaque characterization by OCT: image artifacts in native coronary arteries,” JACC Cardiovasc. Imaging4(7), 810–813 (2011).
[CrossRef] [PubMed]

G. van Soest, T. Goderie, E. Regar, S. Koljenović, G. L. van Leenders, N. Gonzalo, S. van Noorden, T. Okamura, B. E. Bouma, G. J. Tearney, J. W. Oosterhuis, P. W. Serruys, and A. F. van der Steen, “Atherosclerotic tissue characterization in vivo by optical coherence tomography attenuation imaging,” J. Biomed. Opt.15(1), 011105 (2010).
[CrossRef] [PubMed]

van der Steen, A. F. W.

G. J. Tearney, E. Regar, T. Akasaka, T. Adriaenssens, P. Barlis, H. G. Bezerra, B. Bouma, N. Bruining, J.- Cho, S. Chowdhary, M. A. Costa, R. de Silva, J. Dijkstra, C. Di Mario, D. Dudeck, E. Falk, M. D. Feldman, P. Fitzgerald, H. Garcia, N. Gonzalo, J. F. Granada, G. Guagliumi, N. R. Holm, Y. Honda, F. Ikeno, M. Kawasaki, J. Kochman, L. Koltowski, T. Kubo, T. Kume, H. Kyono, C. C. S. Lam, G. Lamouche, D. P. Lee, M. B. Leon, A. Maehara, O. Manfrini, G. S. Mintz, K. Mizuno, M.- Morel, S. Nadkarni, H. Okura, H. Otake, A. Pietrasik, F. Prati, L. Räber, M. D. Radu, J. Rieber, M. Riga, A. Rollins, M. Rosenberg, V. Sirbu, P. W. J. C. Serruys, K. Shimada, T. Shinke, J. Shite, E. Siegel, S. Sonada, M. Suter, S. Takarada, A. Tanaka, M. Terashima, T. Troels, S. Uemura, G. J. Ughi, H. M. M. van Beusekom, A. F. W. van der Steen, G.-A. van Es, G. van Soest, R. Virmani, S. Waxman, N. J. Weissman, G. Weisz, and International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT), “Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation,” J. Am. Coll. Cardiol.59(12), 1058–1072 (2012).
[CrossRef] [PubMed]

van Es, G. A.

P. W. Serruys, H. E. Luijten, K. J. Beatt, R. Geuskens, P. J. de Feyter, M. van den Brand, J. H. Reiber, H. J. ten Katen, G. A. van Es, and P. G. Hugenholtz, “Incidence of restenosis after successful coronary angioplasty: a time-related phenomenon. A quantitative angiographic study in 342 consecutive patients at 1, 2, 3, and 4 months,” Circulation77(2), 361–371 (1988).
[CrossRef] [PubMed]

van Es, G.-A.

G. J. Tearney, E. Regar, T. Akasaka, T. Adriaenssens, P. Barlis, H. G. Bezerra, B. Bouma, N. Bruining, J.- Cho, S. Chowdhary, M. A. Costa, R. de Silva, J. Dijkstra, C. Di Mario, D. Dudeck, E. Falk, M. D. Feldman, P. Fitzgerald, H. Garcia, N. Gonzalo, J. F. Granada, G. Guagliumi, N. R. Holm, Y. Honda, F. Ikeno, M. Kawasaki, J. Kochman, L. Koltowski, T. Kubo, T. Kume, H. Kyono, C. C. S. Lam, G. Lamouche, D. P. Lee, M. B. Leon, A. Maehara, O. Manfrini, G. S. Mintz, K. Mizuno, M.- Morel, S. Nadkarni, H. Okura, H. Otake, A. Pietrasik, F. Prati, L. Räber, M. D. Radu, J. Rieber, M. Riga, A. Rollins, M. Rosenberg, V. Sirbu, P. W. J. C. Serruys, K. Shimada, T. Shinke, J. Shite, E. Siegel, S. Sonada, M. Suter, S. Takarada, A. Tanaka, M. Terashima, T. Troels, S. Uemura, G. J. Ughi, H. M. M. van Beusekom, A. F. W. van der Steen, G.-A. van Es, G. van Soest, R. Virmani, S. Waxman, N. J. Weissman, G. Weisz, and International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT), “Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation,” J. Am. Coll. Cardiol.59(12), 1058–1072 (2012).
[CrossRef] [PubMed]

van Leenders, G. J.

G. van Soest, E. Regar, T. P. Goderie, N. Gonzalo, S. Koljenović, G. J. van Leenders, P. W. Serruys, and A. F. van der Steen, “Pitfalls in plaque characterization by OCT: image artifacts in native coronary arteries,” JACC Cardiovasc. Imaging4(7), 810–813 (2011).
[CrossRef] [PubMed]

van Leenders, G. L.

G. van Soest, T. Goderie, E. Regar, S. Koljenović, G. L. van Leenders, N. Gonzalo, S. van Noorden, T. Okamura, B. E. Bouma, G. J. Tearney, J. W. Oosterhuis, P. W. Serruys, and A. F. van der Steen, “Atherosclerotic tissue characterization in vivo by optical coherence tomography attenuation imaging,” J. Biomed. Opt.15(1), 011105 (2010).
[CrossRef] [PubMed]

van Leeuwen, T. G.

F. J. van der Meer, D. J. Faber, J. Perrée, G. Pasterkamp, D. Baraznji Sassoon, and T. G. van Leeuwen, “Quantitative optical coherence tomography of arterial wall components,” Lasers Med. Sci.20(1), 45–51 (2005).
[CrossRef] [PubMed]

F. J. van der Meer, D. J. Faber, D. M. B. Sassoon, M. C. Aalders, G. Pasterkamp, and T. G. van Leeuwen, “Localized measurement of optical attenuation coefficients of atherosclerotic plaque constituents by quantitative optical coherence tomography,” IEEE Trans. Med. Imaging24(10), 1369–1376 (2005).
[CrossRef] [PubMed]

T. G. van Leeuwen, D. J. Faber, and M. C. Aalders, “Measurement of the axial point spread function in scattering media using single-mode fiber based optical coherence tomography,” IEEE J. Sel. Top. Quantum Electron.9(2), 227–233 (2003).
[CrossRef]

van Noorden, S.

G. van Soest, T. Goderie, E. Regar, S. Koljenović, G. L. van Leenders, N. Gonzalo, S. van Noorden, T. Okamura, B. E. Bouma, G. J. Tearney, J. W. Oosterhuis, P. W. Serruys, and A. F. van der Steen, “Atherosclerotic tissue characterization in vivo by optical coherence tomography attenuation imaging,” J. Biomed. Opt.15(1), 011105 (2010).
[CrossRef] [PubMed]

van Soest, G.

G. J. Tearney, E. Regar, T. Akasaka, T. Adriaenssens, P. Barlis, H. G. Bezerra, B. Bouma, N. Bruining, J.- Cho, S. Chowdhary, M. A. Costa, R. de Silva, J. Dijkstra, C. Di Mario, D. Dudeck, E. Falk, M. D. Feldman, P. Fitzgerald, H. Garcia, N. Gonzalo, J. F. Granada, G. Guagliumi, N. R. Holm, Y. Honda, F. Ikeno, M. Kawasaki, J. Kochman, L. Koltowski, T. Kubo, T. Kume, H. Kyono, C. C. S. Lam, G. Lamouche, D. P. Lee, M. B. Leon, A. Maehara, O. Manfrini, G. S. Mintz, K. Mizuno, M.- Morel, S. Nadkarni, H. Okura, H. Otake, A. Pietrasik, F. Prati, L. Räber, M. D. Radu, J. Rieber, M. Riga, A. Rollins, M. Rosenberg, V. Sirbu, P. W. J. C. Serruys, K. Shimada, T. Shinke, J. Shite, E. Siegel, S. Sonada, M. Suter, S. Takarada, A. Tanaka, M. Terashima, T. Troels, S. Uemura, G. J. Ughi, H. M. M. van Beusekom, A. F. W. van der Steen, G.-A. van Es, G. van Soest, R. Virmani, S. Waxman, N. J. Weissman, G. Weisz, and International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT), “Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation,” J. Am. Coll. Cardiol.59(12), 1058–1072 (2012).
[CrossRef] [PubMed]

G. van Soest, E. Regar, T. P. Goderie, N. Gonzalo, S. Koljenović, G. J. van Leenders, P. W. Serruys, and A. F. van der Steen, “Pitfalls in plaque characterization by OCT: image artifacts in native coronary arteries,” JACC Cardiovasc. Imaging4(7), 810–813 (2011).
[CrossRef] [PubMed]

G. van Soest, T. Goderie, E. Regar, S. Koljenović, G. L. van Leenders, N. Gonzalo, S. van Noorden, T. Okamura, B. E. Bouma, G. J. Tearney, J. W. Oosterhuis, P. W. Serruys, and A. F. van der Steen, “Atherosclerotic tissue characterization in vivo by optical coherence tomography attenuation imaging,” J. Biomed. Opt.15(1), 011105 (2010).
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Figures (8)

Fig. 1
Fig. 1

Examples of atherosclerotic plaques. Left image shows a lipid-rich plaque (L); right image a circumferential calcification (C). Asterisk indicates guide-wire shadowing artifact.

Fig. 2
Fig. 2

Flowchart of the image processing algorithm for tissue characterization. Output consists of a tissue image map. Intermediate output is given by the attenuation image-map.

Fig. 3
Fig. 3

Illustration of the fully-automated lumen segmentation procedure. Image (a) shows the polar domain image. Image (b) illustrates the application of the Otsu’s method and morphological operations and image (c) results of the area constrain. Image (d) and (e) show segmentation results before and after scan-conversion respectively. On image (a) the arrow is pointing to the OCT imaging catheter and the asterisk indicates the guide-wire shadowing artifact.

Fig. 4
Fig. 4

A schematic representation of the iterative fitting procedure. From this image it is possible to appreciate how the algorithm tests all the possible solutions for every value of k varying П(di).

Fig. 5
Fig. 5

Attenuation imaging examples. Image (a) contains a lipid-rich plaque (L) and peri-vascular tissue (PV). Image (b) contains a mixed atherosclerotic plaque containing both lipid-rich (L) and calcific (C) tissue; image (c) shows an example of intimal thickening (fibrotic tissue). Automatic analysis correctly depicts lipid-rich tissue with a higher attenuation coefficient. Attenuation images µt(d) are displayed on a color scale from 0 (dark blue) to 12 mm−1 (dark red). Asterisks indicate the guide-wire shadowing artifact.

Fig. 6
Fig. 6

Classification examples. Image (a) shows an example of lipid-rich tissue (L); image (b) a calcified plaque (C); image (c) a fibrotic plaque (F); image (d) a mixed plaque containing both calcific and lipid-rich tissues (arrow). From the images it is possible to appreciate automated characterization of the 3 main plaque components and outliers (last row) by comparing to ground truth (manual analysis - middle row). Asterisks indicate guide-wire shadowing artifact and (†) indicates a side-branch. Color coding: yellow = lipid-rich, green = fibrotic, white = calcific and gray = outliers.

Fig. 7
Fig. 7

Analysis of 3 adjacent frames. Automated tissue characterization procedure shows consistency through multiple images. Asterisk indicates guide-wire shadowing artifact while (L) indicates lipid-rich tissue.

Fig. 8
Fig. 8

3D rendering of an entire vessel volume depicting different plaque components. Multiple adjacent IVOCT images are automatically analyzed and further processed with dedicated software (OsiriX [41]). Prior to rendering, results were visually inspected and manually corrected where needed. Images immediately illustrate the 3D distribution of atherosclerotic tissue in the analyzed vessel. The arrow points to a vessel stenosis presenting the IVOCT minimal lumen area. The red asterisk indicates guide-wire shadowing artifact. Color coding: yellow = lipid-rich, white = calcific tissue and orange-to-gray rendering of the vessel wall.

Tables (3)

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Table 1 Attenuation and Backscattering for the Main Atherosclerotic Plaque Components [12]

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Table 2 Definitions for the First and Second Order Statistical Features Used in This Study

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Table 3 Measured Values of Optical Properties and Textural Features for the Different Plaque Typesa

Equations (6)

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I(d) I 0 exp( μ t d)
T(d)= [ ( d x 0 z 0 ) 2 +1 ] 1/2
I(d)T(d) I 0 exp( μ t d)
I(d)T(d) i=1 k I 0,i exp( μ t,i d) (d d i )
(d d i ) ={ 0 otherwise 1 d i +t<d< d i+1
I 0,i = I 0,i ( d i +t)

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