Quantitative intravascular biological fluorescence-ultrasound imaging of coronary and peripheral arteries in vivo

Eur Heart J Cardiovasc Imaging. 2017 Nov 1;18(11):1253-1261. doi: 10.1093/ehjci/jew222.

Abstract

Aims: (i) to evaluate a novel hybrid near-infrared fluorescence-intravascular ultrasound (NIRF-IVUS) system in coronary and peripheral swine arteries in vivo; (ii) to assess simultaneous quantitative biological and morphological aspects of arterial disease.

Methods and results: Two 9F/15MHz peripheral and 4.5F/40MHz coronary near-infrared fluorescence (NIRF)-IVUS catheters were engineered to enable accurate co-registrtation of biological and morphological readings simultaneously in vivo. A correction algorithm utilizing IVUS information was developed to account for the distance-related fluorescence attenuation due to through-blood imaging. Corrected NIRF (cNIRF)-IVUS was applied for in vivo imaging of angioplasty-induced vascular injury in swine peripheral arteries and experimental fibrin deposition on coronary artery stents, and of atheroma in a rabbit aorta, revealing feasibility to intravascularly assay plaque structure and inflammation. The addition of ICG-enhanced NIRF assessment improved the detection of angioplasty-induced endothelial damage compared to standalone IVUS. In addition, NIRF detection of coronary stent fibrin by in vivo cNIRF-IVUS imaging illuminated stent pathobiology that was concealed on standalone IVUS. Fluorescence reflectance imaging and microscopy of resected tissues corroborated the in vivo findings.

Conclusions: Integrated cNIRF-IVUS enables simultaneous co-registered through-blood imaging of disease related morphological and biological alterations in coronary and peripheral arteries in vivo. Clinical translation of cNIRF-IVUS may significantly enhance knowledge of arterial pathobiology, leading to improvements in clinical diagnosis and prognosis, and helps to guide the development of new therapeutic approaches for arterial diseases.

Keywords: IVUS; NIRF; fluorescence imaging; molecular imaging.

Publication types

  • Validation Study

MeSH terms

  • Algorithms
  • Animals
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Artery Disease / pathology
  • Coronary Vessels / diagnostic imaging*
  • Coronary Vessels / pathology
  • Peripheral Vascular Diseases / diagnostic imaging*
  • Peripheral Vascular Diseases / pathology
  • Plaque, Atherosclerotic / diagnostic imaging
  • Plaque, Atherosclerotic / pathology
  • Rabbits
  • Spectrometry, Fluorescence / methods*
  • Spectroscopy, Near-Infrared / methods*
  • Stents
  • Swine
  • Ultrasonography, Interventional / methods*