Optical coherence tomography optical biopsy with a short photonic needle
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
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. 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. 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
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
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. 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
Editor's Notes
To date, there are two MGH prototype systems, with another under construction. All optics and electronics reside within a portable enclosure that can easily be transported to the clinical site. A photograph of one the the MGH OCT systems is shown in the upper right hand corner of this slide.
A videoendoscopy image, present in the lower right hand corner of this slide, shows the typical view of the OCT catheter protruding through the accessory port. Light emanates from the OCT catheter in a direction that is perpendicular to the axis of the endoscope. The beam scans along the side of the hollow organ in a linear fashion.