Published online before print December 9, 2002, doi: 10.1161/01.CIR.0000044384.41037.43
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(Circulation. 2003;107:113.)
© 2003 American Heart Association, Inc.
Basic Science Reports |
Quantification of Macrophage Content in Atherosclerotic Plaques by Optical Coherence Tomography
From Wellman Laboratories of Photomedicine (G.J.T., K.H.S., C.R.K., M.S., B.E.B.), Department of Pathology (G.J.T., S.L.H., H.T.A.), Cardiology Division (H.Y., I.-K.J.), and Department of Radiology (E.F.H.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass; and First Department of Internal Medicine (H.Y.), Kinki University School of Medicine, Osakasayama, Osaka, Japan.
Correspondence to Guillermo J. Tearney, MD, PhD, Massachusetts General Hospital, 40 Blossom St, BAR 703, Boston, MA 02114. E-mail tearney{at}helix.mgh.harvard.edu
Background— Macrophage degradation of fibrous cap matrix is an important contributor to atherosclerotic plaque instability. An imaging technology capable of identifying macrophages in patients could provide valuable information for assessing plaque vulnerability. Optical coherence tomography (OCT) is a new intravascular imaging modality that allows cross-sectional imaging of tissue with a resolution of 
10 µm. The aim of this study was to investigate the use of OCT for identifying macrophages in fibrous caps.
Methods and Results— OCT images of 26 lipid-rich atherosclerotic arterial segments obtained at autopsy were correlated with histology. Cap macrophage density was quantified morphometrically by immunoperoxidase staining with CD68 and smooth muscle actin and compared with the standard deviation of the OCT signal intensity at corresponding locations. There was a high degree of positive correlation between OCT and histological measurements of fibrous cap macrophage density (r=0.84, P<0.0001) and a negative correlation between OCT and histological measurements of smooth muscle actin density (r=-0.56, P<0.005). A range of OCT signal standard deviation thresholds (6.15% to 6.35%) yielded 100% sensitivity and specificity for identifying caps containing >10% CD68 staining.
Conclusions— The high contrast and resolution of OCT enables the quantification of macrophages within fibrous caps. The unique capabilities of OCT for fibrous cap characterization suggest that this technology may be well suited for identifying vulnerable plaques in patients.
Key Words: atherosclerosis • catheters • imaging • tomography • plaque
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