Quantitative Ex Vivo and In Vivo Comparison of Lumen Dimensions Measured by Optical Coherence Tomography and Intravascular Ultrasound in Human Coronary Arteries

Introduction and objectives The relationship between the lumen dimensions obtained in human coronary arteries using intravascular ultrasound (IVUS) and those obtained using optical coherence tomography (OCT) is not well understood. The objectives were to compare the lumen measurement obtained ex vivo in human coronary arteries using IVUS, OCT, and histomorphometry, and in vivo in patients using IVUS and OCT with and without balloon occlusion. Methods Ex vivo study: the lumen areas of matched anatomical sections of human coronary arteries were measured using IVUS, OCT, and histology. In vivo study: the lumen areas in matched sections were measured using IVUS and OCT with and without occlusion. Results Ex vivo: in the 8 specimens studied, the lumen area obtained using OCT and IVUS was larger than that obtained using histomorphometry: mean difference 0.8 (1) mm2 (28%) for OCT and 1.3 (1.1) mm2 (40%) for IVUS. In vivo: in the 5 vessels analyzed, the lumen area obtained using IVUS was larger than that obtained using OCT: mean difference 1.67 (0.54) mm2 (33.7%) for IVUS relative to OCT with occlusion and 1.11 (0.53) mm2 (21.5%) relative to OCT without occlusion. The lumen area obtained using OCT without occlusion was larger than that obtained using OCT with occlusion: mean difference 0.61 (0.23) mm2 (13%). Conclusions In fixed human coronary arteries, both IVUS and OCT overestimated the lumen area compared with histomorphometry. In vivo the lumen dimensions obtained using IVUS were larger than those obtained using OCT, with or without occlusion. Moreover, the OCT image acquisition technique (ie, with or without occlusion) also had an impact on lumen measurement.