Three-Dimensional Fourier-Domain Optical Coherence Tomography Imaging: Advantages and Future Development

Automated A-line coronary plaque classification of intravascular optical coherence tomography images using handcrafted features and large datasets

We developed machine learning methods to identify fibrolipidic and fibrocalcific A-lines in intravascular optical coherence tomography (IVOCT) images using a comprehensive set of handcrafted features. We incorporated features developed in previous studies (e.g., optical attenuation and A-line peaks). In addition, we included vascular lumen morphology and three-dimensional (3-D) digital edge and texture features. Classification methods were developed using expansive datasets (∼7000  images), consisting of both clinical in-vivo images and an ex-vivo dataset, which was validated using 3-D cryo-imaging/histology. Conditional random field was used to perform 3-D classification noise cleaning of classification results. We tested various multiclass approaches, classifiers, and feature selection schemes and found that a three-class support vector machine with minimal-redundancy-maximal-relevance feature selection gave the best performance. We found that inclusion of our morphological and 3-D features improved overall classification accuracy. On a held-out test set consisting of >1700 images, we obtained an overall accuracy of 81.58%, with the following (sensitivity/specificity) for each class: other (81.43/89.59), fibrolipidic (94.48/87.32), and fibrocalcific (74.82/95.28). The en-face views of classification results showed that automated classification easily captured the preponderance of a disease segment (e.g., a calcified segment had large regions of fibrocalcific classifications). Finally, we demonstrated proof-of-concept for streamlining A-line classification output with existing fibrolipidic and fibrocalcific boundary segmentation methods, to enable fully automated plaque quantification. The results suggest that our classification approach is a viable step toward fully automated IVOCT plaque classification and segmentation for live-time treatment planning and for offline assessment of drug and biologic therapeutics.

3-D Stent Detection in Intravascular OCT Using a Bayesian Network and Graph Search

Worldwide, many hundreds of thousands of stents are implanted each year to revascularize occlusions in coronary arteries. Intravascular optical coherence tomography is an important emerging imaging technique, which has the resolution and contrast necessary to quantitatively analyze stent deployment and tissue coverage following stent implantation. Automation is needed, as current, it takes up to 16 h to manually analyze hundreds of images and thousands of stent struts from a single pullback. For automated strut detection, we used image formation physics and machine learning via a Bayesian network, and 3-D knowledge of stent structure via graph search. Graph search was done on en face projections using minimum spanning tree algorithms. Depths of all struts in a pullback were simultaneously determined using graph cut. To assess the method, we employed the largest validation data set used so far, involving more than 8000 clinical images from 103 pullbacks from 72 patients. Automated strut detection achieved a 0.91±0.04 recall, and 0.84±0.08 precision. Performance was robust in images of varying quality. This method can improve the workflow for analysis of stent clinical trial data, and can potentially be used in the clinic to facilitate real-time stent analysis and visualization, aiding stent implantation.