open access

Vol 25, No 5 (2018)
Original articles — Interventional cardiology
Published online: 2018-09-20
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A formula to calculate the contrast volume required for optimal imaging quality in optical coherence tomography with non-occlusive technique

Juan Luis Gutiérrez-Chico, Carlos Cortés, Michele Schincariol, Milosz Jaguszewski
DOI: 10.5603/CJ.a2018.0112
·
Pubmed: 30246237
·
Cardiol J 2018;25(5):574-581.

open access

Vol 25, No 5 (2018)
Original articles — Interventional cardiology
Published online: 2018-09-20

Abstract

Background: Non-occlusive technique is universally accepted for acquisition of coronary optical coherence tomography (OCT), but the amount of contrast infused is still inconsistently calculated. Proposed herein, is an empirical formula for accurate contrast volume calculation.

Methods: In an observational prospective study, contrast volume of consecutive patients undergoing OCT was either calculated with formula, or eyeballed based on manufacturer recommendations. The quality of pullback, defined as % of high quality cross-sections (CS) in the segment of interest (SOI), was analyzed by two independent operators and compared between groups, together with the amount of contrast per pullback.

Results: Sixty patients (115 pullbacks, 4252 CS) were imaged using the formula, vs. 18 patients (22 pullbacks, 777 CS) eyeballing the contrast volume. The formula group used 18 mm/s as pullback speed more often (82.6% vs. 40.9%, p = 0.0001), but there were no significant differences between groups in SOI length or vessel imaged. The formula resulted in higher pullback quality than eyeballing (96.55% vs. 63.55%, p < 0.0001), interobserver agreement Kappa 0.903 (p < 0.0001), and tended to use less contrast per pullback than the eyeball group (13.03 mL vs. 14.55 mL, p = 0.057). After adjusting for pullback speed, SOI length and vessel in multivariate linear regression, the use of the formula significantly reduced the amount of contrast in 4.50 mL on average.

Conclusions: Optical coherence tomography acquisition with the non-occlusive technique can be substantially eased with the use of a novel formula to calculate the contrast volume required. This method optimises the quality of the images whilst reducing the amount of contrast per pullback.

Abstract

Background: Non-occlusive technique is universally accepted for acquisition of coronary optical coherence tomography (OCT), but the amount of contrast infused is still inconsistently calculated. Proposed herein, is an empirical formula for accurate contrast volume calculation.

Methods: In an observational prospective study, contrast volume of consecutive patients undergoing OCT was either calculated with formula, or eyeballed based on manufacturer recommendations. The quality of pullback, defined as % of high quality cross-sections (CS) in the segment of interest (SOI), was analyzed by two independent operators and compared between groups, together with the amount of contrast per pullback.

Results: Sixty patients (115 pullbacks, 4252 CS) were imaged using the formula, vs. 18 patients (22 pullbacks, 777 CS) eyeballing the contrast volume. The formula group used 18 mm/s as pullback speed more often (82.6% vs. 40.9%, p = 0.0001), but there were no significant differences between groups in SOI length or vessel imaged. The formula resulted in higher pullback quality than eyeballing (96.55% vs. 63.55%, p < 0.0001), interobserver agreement Kappa 0.903 (p < 0.0001), and tended to use less contrast per pullback than the eyeball group (13.03 mL vs. 14.55 mL, p = 0.057). After adjusting for pullback speed, SOI length and vessel in multivariate linear regression, the use of the formula significantly reduced the amount of contrast in 4.50 mL on average.

Conclusions: Optical coherence tomography acquisition with the non-occlusive technique can be substantially eased with the use of a novel formula to calculate the contrast volume required. This method optimises the quality of the images whilst reducing the amount of contrast per pullback.

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Keywords

tomography, optical coherence; coronary heart disease

About this article
Title

A formula to calculate the contrast volume required for optimal imaging quality in optical coherence tomography with non-occlusive technique

Journal

Cardiology Journal

Issue

Vol 25, No 5 (2018)

Pages

574-581

Published online

2018-09-20

DOI

10.5603/CJ.a2018.0112

Pubmed

30246237

Bibliographic record

Cardiol J 2018;25(5):574-581.

Keywords

tomography
optical coherence
coronary heart disease

Authors

Juan Luis Gutiérrez-Chico
Carlos Cortés
Michele Schincariol
Milosz Jaguszewski

References (5)
  1. Gutiérrez-Chico JL, Alegría-Barrero E, Teijeiro-Mestre R, et al. Optical coherence tomography: from research to practice. Eur Heart J Cardiovasc Imaging. 2012; 13(5): 370–384.
  2. Windecker S, Kolh P, Alfonso F, et al. 2014 ESC/EACTS Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J. 2014; 35(37): 2541–2619.
  3. Prati F, Cera M, Ramazzotti V, et al. Safety and feasibility of a new non-occlusive technique for facilitated intracoronary optical coherence tomography (OCT) acquisition in various clinical and anatomical scenarios. EuroIntervention. 2007; 3(3): 365–370.
  4. Prati F, Cera M, Ramazzotti V, et al. From bench to bedside: a novel technique of acquiring OCT images. Circ J. 2008; 72(5): 839–843.
  5. Bezerra HG, Costa MA, Guagliumi G, et al. Intracoronary optical coherence tomography: a comprehensive review clinical and research applications. JACC Cardiovasc Interv. 2009; 2(11): 1035–1046.

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