Computer-based image analysis of optical coherence tomography images differentiated red and white intracoronary thrombi with high accuracy, achieving an area under the curve of 0.96 for mean backscatter.
Observational (n=30)
Does computer image analysis accurately differentiate intracoronary thrombus type by OCT compared to visual assessment in patients with STEMI?
Computer-based OCT image analysis using attenuation, backscatter, and grayscale intensity can accurately differentiate red and white thrombi, offering a less subjective method than visual assessment.
Effect estimate: AUC 0.96 (95% CI 0.89-1.00)
BACKGROUND: Analysis of intracoronary thrombus type by optical coherence tomography (OCT) imaging is highly subjective. We aimed to compare a newly developed image analysis method to subjective visual classification of thrombus type identified by OCT. METHODS: Thirty patients with acute ST elevation myocardial infarction were included. Thrombus type visually classified by two independent readers was compared with analysis using QCU-CMS software. RESULTS: Repeatability of the computer-based measurements was good. By using a ROC, area under curve values for discrimination of white and red thrombi were 0.92 (95% confidence intervals (CI) 0.83-1.00) for median attenuation, 0.96 (95% CI 0.89-1.00) for mean backscatter and 0.96 (95% CI 0.89-1.00) for mean grayscale intensity. Median attenuation of 0.57 mm-1 (sensitivity 100%, specificity 71%), mean backscatter of 5.35 (sensitivity 92%, specificity 94%) and mean grayscale intensity of 120.1 (sensitivity 85%, specificity 100%) were identified as the best cut-off values to differentiate between red and white thrombi. CONCLUSIONS: Attenuation, backscatter and grayscale intensity of thrombi in OCT images differentiated red and white thrombi with high sensitivity and specificity. Measurement of these continuous parameters can be used as a less user-dependent method to characterize in vivo thrombi. The clinical significance of these findings needs to be tested in further studies.
Kaivosoja et al. (Mon,) conducted a observational in Acute ST elevation myocardial infarction (STEMI) (n=30). Computer image analysis (QCU-CMS software) vs. Visual assessment was evaluated on Discrimination of white and red thrombi (mean backscatter) (AUC 0.96, 95% CI 0.89-1.00). Computer-based image analysis of optical coherence tomography images differentiated red and white intracoronary thrombi with high accuracy, achieving an area under the curve of 0.96 for mean backscatter.
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