Every year, 100s of thousands of patients in the US are treated with intravascular stents. Although the technology has advanced and drug eluting metal stents hinder restenosis, there remains significant room for improvement. Stent parameters include drug choice, bioresorbable versus metal, mechanical design, coatings to stimulate cell coverage, etc. To optimize designs, sensitive, in vivo assessments are needed for preclinical and clinical studies. Intravascular OCT (iOCT) alone provides the resolution and contrast s necessary for in vivo interrogation of vascular healing;stent deployment issues such as malposition;and assessment of stent strut tissue coverage. The Cardiovascular Imaging Core Laboratory at CWRU analyzes iOCT images as a service to numerous clinical and preclinical trials from around the world. An analyst takes many hours to analyze manually a single stent, greatly limiting the size and number of studies. Despite training and quality assurance measures, inter-analyst variability limits the ability to determine changes between stent types. We will develop highly automated software to greatly speed analysis, improve reproducibility, increase accuracy, etc. Careful evaluations/validations will be performed using our database of >1500 manually analyzed stents, and new phantom and pig studies. With the successful completion of this research and development, we will deliver well-validated, highly automated software, which will enable routine use of iOCT for sensitive evaluation of emerging stent technologies, thereby providing greatly improved treatments of cardiovascular disease. In addition, fast, robust software will contribute to clinical usage of iOCT for assessment of stent deployment and healing of a stented vessel.

Public Health Relevance

We will develop methods for improved in vivo assessment of intravascular stents, the treatment of choice for 100s of thousands of patients, suffering from ischemic heart disease, in the US every year. Our methods will enable optimization of stent technologies for improved treatment of vascular disease.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL114406-02
Application #
8724992
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Danthi, Narasimhan
Project Start
2013-09-01
Project End
2017-05-31
Budget Start
2014-06-01
Budget End
2015-05-31
Support Year
2
Fiscal Year
2014
Total Cost
Indirect Cost
Name
Case Western Reserve University
Department
Biomedical Engineering
Type
Biomed Engr/Col Engr/Engr Sta
DUNS #
City
Cleveland
State
OH
Country
United States
Zip Code
44106
Prabhu, David; Mehanna, Emile; Gargesha, Madhusudhana et al. (2016) 3D registration of intravascular optical coherence tomography and cryo-image volumes for microscopic-resolution validation. Proc SPIE Int Soc Opt Eng 9788:
Shalev, Ronny; Gargesha, Madhusudhana; Prabhu, David et al. (2016) Processing to determine optical parameters of atherosclerotic disease from phantom and clinical intravascular optical coherence tomography three-dimensional pullbacks. J Med Imaging (Bellingham) 3:024501
Prabhu, David; Mehanna, Emile; Gargesha, Madhusudhana et al. (2016) Three-dimensional registration of intravascular optical coherence tomography and cryo-image volumes for microscopic-resolution validation. J Med Imaging (Bellingham) 3:026004
Gargesha, Madhusudhana; Shalev, Ronny; Prabhu, David et al. (2015) Parameter estimation of atherosclerotic tissue optical properties from three-dimensional intravascular optical coherence tomography. J Med Imaging (Bellingham) 2:016001
Galon, Micheli Zanotti; Wang, Zhao; Bezerra, Hiram G et al. (2015) Differences determined by optical coherence tomography volumetric analysis in non-culprit lesion morphology and inflammation in ST-segment elevation myocardial infarction and stable angina pectoris patients. Catheter Cardiovasc Interv 85:E108-15
Wang, Zhao; Jenkins, Michael; Linderman, George et al. (2015) 3-D Stent Detection in Intravascular OCT Using a Bayesian Network and Graph Search. IEEE Trans Med Imaging :
Mehanna, Emile; Bezerra, Hiram G; Prabhu, David et al. (2013) Volumetric characterization of human coronary calcification by frequency-domain optical coherence tomography. Circ J 77:2334-40
Wang, Zhao; Chamie, Daniel; Bezerra, Hiram G et al. (2012) Volumetric quantification of fibrous caps using intravascular optical coherence tomography. Biomed Opt Express 3:1413-26
Lu, Hong; Gargesha, Madhusudhana; Wang, Zhao et al. (2012) Automatic stent detection in intravascular OCT images using bagged decision trees. Biomed Opt Express 3:2809-24
Mehanna, Emile Aziz; Attizzani, Guilherme Ferragut; Kyono, Hiroyuki et al. (2011) Assessment of coronary stent by optical coherence tomography, methodology and definitions. Int J Cardiovasc Imaging 27:259-69

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