SHAPE Society

1. Plaque Characterization
with OCT

2. LightLab OCT
Optical Coherence
Tomography (OCT) is a new
class of ultra high-resolution
imaging technology using
near infrared light.
In addition to morphological imaging,
LightLab OCT is capable of:
 Spectroscopic Imaging
 Polarization Imaging
 Doppler
 Elastography

3.  Real time Imaging (to 30fps)
 Portable & Modular Design
 Digital System Architecture
LightLab Imaging PlatformLightLab Imaging Platform
(Pending 510(k) Clearance)
LightLab OCT
 .006” micro-optic core
 Microscopic resolution (12 µm)
 .014” ImageWire & Balloon
Imaging System
Catheters

4. Precision Imaging
Intimal ThickeningIntimal Thickening
Human Cadaver, Left Diagonal Branch
Intima
Media
Adventitia

5. Precision Imaging
Ex-vivo LAD
Thin capped FibroatheromaThin capped Fibroatheroma
Lesion
Cap < 60µm
(Renu Virmani, MD, AFIP)

6. NC
Ca++
FC
NC
FC
Ca++ NC necrotic core
calcium
lumen
Precision Imaging
(Renu Virmani, MD, AFIP)
FC fibrous cap

7. Over sampling enables detailedOver sampling enables detailed
interrogationinterrogation
Ex-vivo LAD, LightLab .014” ImageWire(Renu Virmani, MD, AFIP)
Precision Imaging
Core
Thrombus
Core

8. Precision Imaging
OCT Cine Pullback
Human Cadaver Circumflex Artery
Thin Capped LesionsThin Capped Lesions

9. Precision Imaging
Pull-back in stentPull-back in stent (note early side branch)(note early side branch)
In-vivo HumanIn-vivo Human
.014” ImageWire
Prof. Eberhard Grube, Siegburg Heart Center

10. Precision Imaging
In-vivo Human Lesion 400 micrometer capIn-vivo Human Lesion 400 micrometer cap
.014” ImageWire
Prof. Eberhard Grube, Siegburg Heart Center

11. Bringing a microscope into theBringing a microscope into the
coronaries improves the clinicians abilitycoronaries improves the clinicians ability
to:to:
 Select the appropriate therapy
 Titrate the delivery of specific therapies
 Direct the delivery to targeted lesions
 Develop entire new therapeutic approaches
Precision Therapy

12. Imaging BalloonImaging Balloon
In-vivo pig, LightLab Imaging Balloon, 3mm
and .014” ImageWire – No Flush
Brigham&Women’s Hospital ECI Lab
Real-time inflation visualization
Precision Therapy

13. Stent and ThrombiStent and Thrombi
Full Screen
In-vivo pig, LightLab .014” ImageWire
Dr. Campbell Rogers, Brigham&Women’s Hospital ECI Lab
Precision Therapy
Zoom

14. In-vivo Human Stent in StentIn-vivo Human Stent in Stent
.014” ImageWire
Prof. Eberhard Grube, Siegburg Heart Center
Precision Therapy

15.  Upgrades
• Polarization Imaging
• Spectroscopic Imaging
• Doppler
• Elastography
LightLab Imaging Platform – FutureLightLab Imaging Platform – Future
(Pending 510(k) Clearance)
LightLab OCT Technology
 Sub selective flush
 Forward looking lens designs
 Integrated therapeutic catheters
Imaging System
Catheters

16. Polarization
Information for a better understanding ofInformation for a better understanding of
microanatomic plaque characteristicsmicroanatomic plaque characteristics
Evaluate plaque
structure and
orderliness
Grey Scale
Detailed
Morphological
understanding
Cap thickness, identify
fissures, calcium, lipid
Cap/plaque Fiber
Spectroscopy
Determine
chemical content
of visualized
lesions
Lipid concentration
Polarization
LightLab OCT Technology

17. Different tissues exhibit differentDifferent tissues exhibit different
polarization effectspolarization effects
OCT
is inherently sensitive to
changes in the polarization
of the probe beam.
Birefringence
is the major source
of contrast in polarization-
sensitive OCT imaging.
Very High
Very low
Media (healthy)
Cholesterol crystals
Soft (lipid) plaque
Fibrotic plaque
Intima (healthy)
Calcified plaque
Structure
Birefringence
LightLab OCT Technology

18. Grayscale Polarization Difference
Table
Surface
Laminated
Structure
LightLab OCT Technology
(Birefringent)
(Non-Birefringent)
Polarization helps differentiate organizedPolarization helps differentiate organized
(linear) from disorganized structures(linear) from disorganized structures

19. Magnitude
Polarization
Combined
Grey scale and polarization information may beGrey scale and polarization information may be
combined to localize and identify tissuecombined to localize and identify tissue
characteristicscharacteristics
Platform FuturesPlatform Futures

20. Polarization
Evaluate plaque
structure and
orderliness
Grey Scale
Detailed
Morphological
understanding
Cap thickness, identify
fissures, calcium, lipid
Cap/plaque Fiber
Spectroscopy
Determine
chemical content
of visualized
lesions
Lipid concentration
Polarization
LightLab OCT Technology
Information for a better understanding ofInformation for a better understanding of
microanatomic plaque characteristicsmicroanatomic plaque characteristics

21. Lipid imaging in phantom
Spectroscopic image
Lipid+calcium Protein+calcium
Gray-scale image
Lipid+calcium Protein+calcium
OCT Spectroscopy identifies differences in
composition
LightLab OCT Technology

22. Today’sToday’s
State-of-the-artState-of-the-art
OpticalOptical
CoherenceCoherence
TomographyTomography
100µm
In vivo 1µm OCT
(Image Courtesy of J. Fujimoto, MIT)
The Future of OCT Imaging

23. Changing the way
you see things.