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Optical coherence tomography imaging of coronary atherosclerosis is affected by intraobserver and interobserver variability

Optical coherence tomography imaging of coronary atherosclerosis is affected by intraobserver and interobserver variability
Optical coherence tomography imaging of coronary atherosclerosis is affected by intraobserver and interobserver variability
Aims: Optical coherence tomography (OCT) has emerged as a novel imaging modality that allows plaque classification through identification of features including lipid, calcification and fibrous cap. However, subtle changes in light attenuation as the optical beam traverses the plaque in vivo are challenging to interpret and data on strength of observer agreement are minimal. Thus, we sought to assess both the intra and interobserver variability for plaque composition/classification using OCT.

Methods: OCT imaging was performed in 50 patients prior to percutaneous coronary intervention. Analysis was performed offline by two independent, experienced OCT operators. Target lesion luminal dimensions and plaque composition were assessed at minimal luminal area (MLA) and at five 1-mm longitudinal intervals proximal and distal to the MLA. An OCT thin-capped fibroatheroma (OCT-TCFA) was defined as greater than 90 degree lipid arc with minimal fibrous cap thickness less than 0.85 [mu]m.

Results: Overall, 540 frames of OCT were included and exceptional consistency was seen for all measures of luminal geometry [all intraclass correlation coefficients (ICC) >0.97, P < 0.001]. Intraobserver agreements for calcification and lipid arc were strong (both ICC >0.84, P < 0.001), whereas interobserver agreement was higher for calcium (ICC 0.76) than lipid (ICC 0.69). Interobserver agreement of minimal fibrous cap thickness was moderate (ICC 0.52, 95% confidence interval 0.45-0.58, P < 0.001], but improved as cap thickness decreased. Overall, intra and interobserver agreements for OCT-defined plaque classification were strong (K = 0.86 and 0.71, respectively).

Conclusion: Luminal dimensions and plaque compositional features identified by OCT are minimally affected by observer variability, permitting dependable plaque classification.
1558-2027
368-373
Brown, Adam J.
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Jaworski, Catherine
b54b12ec-3295-4766-80f0-d70c53590812
Corrigan, Joseph P.
48b0b8dc-19b9-45c5-acee-ec9540fa3de3
de Silva, Ramesh
b32cccbb-ecf7-452c-9ab9-4fd7c41a5a85
Bennett, Martin R.
5ad36367-2129-40ee-a980-ecab6e20210b
Mahmoudi, Michael
f6a55246-399e-4f81-944e-a4b169786e8a
Hoole, Stephen P.
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West, Nick E.J.
3b2ba9a9-0160-4573-91c3-7ea13b0e3850
Brown, Adam J.
f5f4cdcc-8f1e-4d5e-93f2-b31bc9277a82
Jaworski, Catherine
b54b12ec-3295-4766-80f0-d70c53590812
Corrigan, Joseph P.
48b0b8dc-19b9-45c5-acee-ec9540fa3de3
de Silva, Ramesh
b32cccbb-ecf7-452c-9ab9-4fd7c41a5a85
Bennett, Martin R.
5ad36367-2129-40ee-a980-ecab6e20210b
Mahmoudi, Michael
f6a55246-399e-4f81-944e-a4b169786e8a
Hoole, Stephen P.
0a252d38-c77f-46c0-87b6-02a9c6716ccf
West, Nick E.J.
3b2ba9a9-0160-4573-91c3-7ea13b0e3850

Brown, Adam J., Jaworski, Catherine, Corrigan, Joseph P., de Silva, Ramesh, Bennett, Martin R., Mahmoudi, Michael, Hoole, Stephen P. and West, Nick E.J. (2016) Optical coherence tomography imaging of coronary atherosclerosis is affected by intraobserver and interobserver variability. Journal of Cardiovascular Medicine, 17 (5), 368-373. (doi:10.2459/JCM.0000000000000304). (PMID:26406395)

Record type: Article

Abstract

Aims: Optical coherence tomography (OCT) has emerged as a novel imaging modality that allows plaque classification through identification of features including lipid, calcification and fibrous cap. However, subtle changes in light attenuation as the optical beam traverses the plaque in vivo are challenging to interpret and data on strength of observer agreement are minimal. Thus, we sought to assess both the intra and interobserver variability for plaque composition/classification using OCT.

Methods: OCT imaging was performed in 50 patients prior to percutaneous coronary intervention. Analysis was performed offline by two independent, experienced OCT operators. Target lesion luminal dimensions and plaque composition were assessed at minimal luminal area (MLA) and at five 1-mm longitudinal intervals proximal and distal to the MLA. An OCT thin-capped fibroatheroma (OCT-TCFA) was defined as greater than 90 degree lipid arc with minimal fibrous cap thickness less than 0.85 [mu]m.

Results: Overall, 540 frames of OCT were included and exceptional consistency was seen for all measures of luminal geometry [all intraclass correlation coefficients (ICC) >0.97, P < 0.001]. Intraobserver agreements for calcification and lipid arc were strong (both ICC >0.84, P < 0.001), whereas interobserver agreement was higher for calcium (ICC 0.76) than lipid (ICC 0.69). Interobserver agreement of minimal fibrous cap thickness was moderate (ICC 0.52, 95% confidence interval 0.45-0.58, P < 0.001], but improved as cap thickness decreased. Overall, intra and interobserver agreements for OCT-defined plaque classification were strong (K = 0.86 and 0.71, respectively).

Conclusion: Luminal dimensions and plaque compositional features identified by OCT are minimally affected by observer variability, permitting dependable plaque classification.

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Published date: May 2016
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 394531
URI: http://eprints.soton.ac.uk/id/eprint/394531
ISSN: 1558-2027
PURE UUID: 432c9fd1-7e2f-4874-8040-750be1a76a5b
ORCID for Michael Mahmoudi: ORCID iD orcid.org/0000-0003-1293-8461

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Date deposited: 20 May 2016 09:14
Last modified: 26 Nov 2019 01:31

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Contributors

Author: Adam J. Brown
Author: Catherine Jaworski
Author: Joseph P. Corrigan
Author: Ramesh de Silva
Author: Martin R. Bennett
Author: Stephen P. Hoole
Author: Nick E.J. West

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