"Detect and Characterize Atherosclerotic Vulnerable Plaques with Novel Hybrid Imaging Systems." Jones Seminars on Science, Technology, and Society.
Raiyan Zaman, Assistant Professor, Dept. of Radiology, Harvard Medical School.
April, 12, 2019.
Every 34 seconds someone has a heart attack, and every minute someone dies from a CAD-related event. Illness from CAD including heart attack and stroke strains the American health system by costing $312.6 billion each year due to high cost for healthcare services, medications, and lost productivity. Thin-cap fibro atheroma (TCFA), unstable lesions, which are prone to rupture causing 60-70% CAD events resulting in substantial morbidity and mortality worldwide. Early clinical diagnosis and effective risk stratification of these lesions has the potential to dramatically impact management of CAD and prevent progression to catastrophic events. However, their small size, and complex morphological/biological features make early detection and risk assessment difficult. Current CAD imaging methods mainly focus on detecting plaque burden and degree of stenosis, and lack detailed plaque characterization and biological activities, making heart attack/stroke prediction difficult. Several imaging techniques including intravascular ultrasound, optical coherent tomography, and near-infrared spectroscopy have been investigated to identify TCFA with limited success. Thus, the current gold standard for detecting CAD in clinics is angiography, which only evaluates luminal encroachment at advance stage, without providing critical information on plaque content, extent, and biology. To enable detection and characterization of vulnerable plaque structure and biology, we developed catheter-based hybrid imaging modalities such as (1) fiber-optic catheter system for dual optical imaging, (2) scintillating-balloon-enabled fiber-optic system for radionuclide imaging, and (3) circumferential-intravascular-radioluminescence-photoacoustic-imaging. These systems showed promising results in detecting vulnerable plaques early and quantifying their disease compositions in ex vivo mouse atherosclerotic models, ex vivo human carotid artery plaque specimens, and in vivo rabbit abdominal aorta with high sensitivity, specificity, and spatial resolution.
0 Comments