High-Definition Intravascular Ultrasound versus Optical Coherence Tomography: Lumen Size and Plaque Morphology

Authors

• Wei Wu, Miller School of Medicine
• Shijia Zhao, Miller School of Medicine
• Akshat Banga, Miller School of Medicine
• Yash Vardhan Trivedi, Miller School of Medicine
• Vineeth S. Dasari, Miller School of Medicine
• Parth Munjal, Miller School of Medicine
• Rakshita Ramesh Bhat, Miller School of Medicine
• Ruben K.A. Tapia-Orihuela, Miller School of Medicine
• Usama M. Oguz, Miller School of Medicine
• Hammad Zafar, Miller School of Medicine
• Haritha Darapaneni, Miller School of Medicine
• Nikolaos Spilias, Miller School of Medicine
• Jessica Wagner, University of Nebraska-Lincoln
• Stephen Morin, University of Nebraska-Lincoln
• Amanda DeVos, University of Minnesota - Minneapolis
• Pual A. Iaizzo, University of Minnesota - Minneapolis
• Akiko Maehara, Columbia University Irving Medical Center
• Evan S. Shlofmitz, St. Francis Hospital & Heart Center
• Ziad A. Ali, St. Francis Hospital & Heart Center
• Emmanouil Brilakis, Minneapolis Heart Institute
• George D. Dangas, Icahn School of Medicine at Mount Sinai
• Thomas Johnson, University of Bristol
• Yiannis S. Chatzizisis, Miller School of MedicineFollow

ORCID IDs

Wu https://orcid.org/0000-0003-0734-1636

Banga https://orcid.org/0000-0003-2626-8219

Munjal https://orcid.org/0009-0004-7665-4737

Tapia Orihuela https://orcid.org/0000-0002-7446-8170

Oguz https://orcid.org/0000-0002-8135-5422

Spilias https://orcid.org/0000-0002-1529-1459

Morin https://orcid.org/0000-0002-8652-0511

Document Type

Article

Date of this Version

2025

Citation

Journal of the Society for Cardiovascular Angiography & Interventions (2025) 4: 102520

doi: 10.1016/j.jscai.2024.102520

Comments

Open access

License: CC BY 4.0

Abstract

Complex percutaneous coronary interventions rely on advanced intravascular imaging techniques, such as intravascular ultrasound (IVUS) and optical coherence tomography (OCT). This study aims to compare the accuracy of the latest high-definition intravascular ultrasound (HD IVUS) and OCT technologies in measuring coronary lumen dimensions and assessing plaque morphology.   We compared HD IVUS and OCT in 8 silicone models using microcomputed tomography as the ground truth. We also compared HD IVUS vs OCT in 12 coronary arteries from 9 patients.   In the silicone models, the latest HD IVUS (AVVIGO+, Boston Scientific) system overestimated lumen dimensions compared to microcomputed tomography by +0.06 ± 0.05 mm for mean lumen diameter (MLD). OCT (Ultreon 2.0, Abbott) underestimated lumen dimensions by –0.17 ± 0.06 mm for MLD, with the underestimation being greater for lumen diameters ≥5.0 mm. In clinical cases, the latest HD IVUS (AVVIGO+) system yielded larger lumen dimensions compared to OCT (Ultreon 2.0) by +0.12 ± 0.11 mm for MLD, and the earlier HD IVUS (POLARIS, Boston Scientific) system also showed larger lumen dimensions compared to OCT (AptiVue, Abbott) by +0.26 ± 0.29 mm for MLD. Using OCT as the reference, HD IVUS detected fine wall structures with precision, such as a thin fibrous cap, dissection, and stent struts.   The latest HD IVUS (Avvigo+) tends to overestimate lumen size, whereas OCT (Ultreon 2.0) underestimates it. Experimental data suggest HD IVUS provides more accurate lumen assessment, particularly in larger coronary arteries, although both technologies exhibit comparable overall accuracy in the clinical setting.