Key result
Continuous longitudinal OCT assessment of fibrous cap thickness demonstrated high reproducibility between repeated pullbacks, with the best correlation observed for L-plot mean FCt (ICC 0.952).
Why the study?
The study was conducted to test the reproducibility of optical coherence tomography assessment for lumen area and plaque components, including lipid arc extension and fibrous cap thickness.
What is the most reproducible approach for evaluating fibrous cap thickness in sequential optical coherence tomography studies?
Observational
What is the most reproducible approach for evaluating fibrous cap thickness in sequential optical coherence tomography studies?
Effect estimate: ICC 0.952
Longitudinal measurement in multiple adjacent frames is the most accurate and reproducible approach for sequential fibrous cap thickness assessment using OCT.
BACKGROUND: In this in-vivo human study we tested the reproducibility for optical coherence tomography (OCT) assessment of lumen area (LA) and plaque components measurements, such as lipid arc extension and fibrous cap thickness (FCt).METHODS: We tested the variability of LA, lipid arc and FCt assessments in two repeated OCT pullbacks from the same diseased coronary segment matched using fiduciary anatomical landmarks. In particular, for the reliability of minimal FCt measurement we compared four different approaches based on continuous (longitudinal) or segmental (spot) individuation of smaller thickness: 1) comparison of single minimal FCt individuated alongside all plaque extension in the two pullbacks (Longitudinal (L)-spot minimal FCt value); 2) comparison of the mean FCt values of the plaque in the two pullbacks (L-plot mean FCt value); 3) comparison between the single minimal FCt value obtained in the first pullback and the single FCt obtained in the matched CS of second pullback (L-spot CS matched FCt value); 4) comparison of measurements obtained by visual selection of CS with minimal FCt s in the two pullbacks (single-spot minimal FCt value).RESULTS: From the paired analyses of 20 non culprit lesions (accounting for a total of 387 matched CS), we found a suboptimal in-segment correlation for LA (Intra-Class Coefficient [ICC] 0.731), but a good in-segment correlation for lipid arc (ICC 0.963). Regarding FCt measurement, a high reproducibility was obtained applying continuous assessment; in particular, the best correlation was observed with L-spot minimal FCt value and the L-plot mean FCt (ICC 0.893 and 0.952, respectively) with small inter-pullback differences (confidence intervals less than 0.04 mm).CONCLUSIONS: In this methodological study we observed a good reproducibility for quantitative plaque measurements with OCT confirming its reliability for serial assessment. In particular, longitudinal measurement in multiple adjacent frames seems to be the more accurate and reproducible approach for sequential FCt assessment.
No takes yet. Share an insight, caveat, or question.
Romagnoli et al. (2023) conducted an observational in Coronary artery disease. Optical coherence tomography (OCT) continuous assessment vs. Segmental (spot) assessment was evaluated on Reproducibility of lumen area, lipid arc, and fibrous cap thickness (FCt) measurements (ICC 0.952). Continuous longitudinal OCT assessment of fibrous cap thickness demonstrated high reproducibility between repeated pullbacks, with the best correlation observed for L-plot mean FCt (ICC 0.952).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: