Variability in the measurement of minimum fibrous cap thickness and reproducibility of fibroatheroma classification by optical coherence tomography using manual versus semi-automatic assessment.

Radu, Maria D; Yamaji, Kyohei; García-García, Hector M; Zaugg, Serge; Taniwaki, Masanori; Koskinas, Konstantinos; Serruys, Patrick W; Windecker, Stephan; Dijkstra, Jouke; Räber, Lorenz (2016). Variability in the measurement of minimum fibrous cap thickness and reproducibility of fibroatheroma classification by optical coherence tomography using manual versus semi-automatic assessment. EuroIntervention, 12(8), e987-e997. Europa Digital & Publishing 10.4244/EIJV12I8A162

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AIMS

The minimum fibrous cap thickness (FCT) is considered a major criterion of coronary plaque vulnerability according to autopsy studies. We aimed to assess the reproducibility in the measurement of the optical coherence tomography (OCT)-detected minimum FCT and the agreement in the classification of thin-cap fibroatheroma (TCFA), by a software-based semi-automatic method compared with the manual method.

METHODS AND RESULTS

A total of 50 frames with fibroatheromas (FA) were randomly selected from the Integrated Biomarker Imaging Study-4 (IBIS-4). Two experienced OCT analysts independently measured the minimum FCT at two different time points, manually and by three different semi-automatic software-based algorithms, based on the assessment of light intensity along the axial scan line. A TCFA was defined as an FA with minimum FCT <65 μm. The inter- and intra-observer reproducibility of the manual measurement of the minimum FCT was moderate with an intra-class correlation coefficient (ICC) of 0.71 and 0.79, respectively. The corresponding ICCs by either one of the three semi-automatic algorithms were 0.99. When categorising FA according to the minimum FCT based on the manual assessment, the inter- and intra-observer agreement was poor (κ=0.23) and moderate (κ=0.50), respectively. In contrast, the semi-automatic assessment showed perfect agreement for both inter- and intra-observer assessments (κ=0.90-1.00 and 1.00, respectively).

CONCLUSIONS

While semi-automatic assessment of FCT and TCFA classification was associated with excellent reproducibility and agreement, manual measurements were associated with a moderate reproducibility and agreement in the quantification of FCT and classification of TCFA.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
UniBE Contributor:	Yamaji, Kyohei, Taniwaki, Masanori, Koskinas, Konstantinos, Windecker, Stephan, Räber, Lorenz
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1774-024X
Publisher:	Europa Digital & Publishing
Language:	English
Submitter:	Judith Liniger
Date Deposited:	28 Nov 2016 16:31
Last Modified:	05 Dec 2022 14:59
Publisher DOI:	10.4244/EIJV12I8A162
PubMed ID:	27721214
URI:	https://boris.unibe.ch/id/eprint/89643