OCT-FLIm Imaging Proven Safe and Feasible for Identifying High-Risk Atheromas: JAMA
South Korea: Researchers have found in a diagnostic feasibility study that OCT-FLIm structural-molecular intracoronary imaging is clinically safe and effective for the detailed characterization of human atheromas, highlighting its potential in diagnosing and understanding high-risk plaques.
The first-in-human clinical study, published in JAMA Cardiology, evaluated a dual-modal imaging technique that integrates fluorescence lifetime imaging (FLIm) with optical coherence tomography (OCT). This novel imaging platform offers the advantage of combining structural insights from OCT with biochemical profiling enabled by FLIm, aiming to provide a comprehensive picture of coronary plaque characteristics.
Conducted between February and August 2022 at a single center, the prospective, open-label trial enrolled 40 patients with significant coronary artery disease (CAD) undergoing revascularization procedures. The study included an equal distribution of patients presenting with acute coronary syndrome (ACS) and chronic stable angina (CSA).
Using specially designed 2.6-F OCT-FLIm catheters, Sunwon Kim, Department of Cardiology, Korea University Ansan Hospital, Ansan, South Korea, and colleagues imaged both culprit and nonculprit coronary lesions during routine procedures. The imaging protocol also included intravascular ultrasound for comparative analysis. The primary goal was to assess FLIm-derived molecular signals specific to different plaque components, such as macrophages, healed plaques, superficial calcification, and fibrosis. A secondary aim involved evaluating the technique’s ability to distinguish disease activity patterns—namely, ACS vs CSA and segments showing rapid angiographic progression vs stable plaques.
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