Optical coherence tomography attenuation imaging for lipid core detection: an ex-vivo validation study

Muthukaruppan Gnanadesigan, Ali Hussain, Steve White, Simon Scoltock, Andreas Baumbach, Antonius van der Steen, Evelyn Regar, Thomas W Johnson, Gijs van Soest

Research output: Contribution to journalArticle (Academic Journal)peer-review

12 Citations (Scopus)
292 Downloads (Pure)


Lipid-core atherosclerotic plaques are associated with disease progression, procedural complications, and cardiac events. Coronary plaque lipid can be quantified in optical coherence tomography (OCT) pullbacks by measurement of lipid arcs and lipid lengths; parameters frequently used in clinical research, but labor intensive and subjective to analyse. In this study, we investigated the ability of quantitative attenuation, derived from intravascular OCT, to detect plaque lipid. Lipid cores are associated with a high attenuation coefficient. We compared the index of plaque attenuation (IPA), a local quantitative measure of attenuation, to the manually measured lipid score (arc and length) on OCT images, and to the plaque characterization ex-vivo. We confirmed a correlation between the IPA and lipid scores (r2 > 0.7). Comparison to histology shows that high attenuation is associated with fibroatheroma, but also with macrophage presence. IPA is a robust, reproducible, and user-independent measure that facilitates quantification of coronary lipid, a potential tool in clinical research and in guiding percutaneous coronary intervention.
Original languageEnglish
Pages (from-to)5-11
Number of pages7
JournalInternational Journal of Cardiovascular Imaging
Issue number1
Early online date12 Sep 2016
Publication statusPublished - Jan 2017


  • Optical coherence tomography
  • Attenuation
  • Lipid core plaque

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