Abstract 13103: Fusion Imaging of Intravascular Ultrasound and Multi-Detector Computed Tomography: A Novel Technique of Tissue Characterization of Coronary Plaques
Background and Purpose: The spectral analyses of radio-frequency ultrasound signals obtained by intravascular ultrasound (RF-IVUS) as well as the CT value of multi-detector coronary CT (MDCT) have been proven to be useful in order to characterize tissue composition within atheroscrelotic plaques. The purpose of this study was to evaluate the feasibility of a novel technique, fusion imaging of RF-IVUS, iMap™ and a 64-row MDCT.
Methods: A total of 38 coronary lesions in patients with coronary artery disease, 18 from patients with unstable angina (UAP) and 20 from stable angina (SAP), were imaged with IVUS and MDCT. The results of tissue characterization according to iMap algorithm as well as CT value-derived classification (calcified area, >200HU, fibrotic area, 50-100HU, lipidic are, 0-50HU) were first compared. Then, fusion imaging of the iMap and MDCT-plaque mapping was performed (Figure).
Results: The necrotic plus lipidic component areas measured by iMap were significantly correlated with lipidic area by MDCT (r=0.43, p<0.01). When limiting data only for patients with unstable angina, this correlation was significantly improved (r=0.71, p<0.001). The fibrotic component area by iMap was significantly correlated with that measured by MDCT (r=0.76,p<0.001). The calcified component area by iMap was not significantly correlated with that by MDCT. Three dimensional fusion imaging of iMap and MDCT plaque map could visualize stereoscopically the distribution of fibrous and lipidic area within plaque. Lipidic plus necrotic area identified by this fusion imaging was more frequently observed in UAP patients than SAP patients (79% vs. 21%, p<0.0001).
Conclusion: Fusion imaging of IVUS and MDCT might be useful for stereoscopically identifying vulnerable plaque in patients with coronary artery disease.
- © 2012 by American Heart Association, Inc.