Plaque Characterization with OCT

LightLab OCT

Optical Coherence Tomography (OCT) is a new class of ultra high-resolution imaging technology using near infrared light.

In addition to morphological imaging,

LightLab OCT is capable of:

Spectroscopic Imaging Polarization Imaging Doppler Elastography

Real time Imaging (to 30fps) Portable & Modular Design Digital System Architecture

LightLab Imaging Platform LightLab Imaging Platform

(Pending 510(k) Clearance)

LightLab OCT

.006” micro-optic core Microscopic resolution (12 µm)

.014” ImageWire & Balloon

Imaging System

Catheters

Precision Imaging

Intimal ThickeningIntimal Thickening

Human Cadaver, Left Diagonal Branch

Intima

Media

Adventitia

Precision Imaging

Ex-vivo LAD

Thin capped FibroatheromaThin capped Fibroatheroma

Lesion

Cap < 60µm

(Renu Virmani, MD, AFIP)

NC

Ca++

FC

NC

FC

Ca++

NC necrotic core

calcium

lumen

Precision Imaging

(Renu Virmani, MD, AFIP)

FC fibrous cap

Over sampling enables detailed Over sampling enables detailed interrogationinterrogation

Ex-vivo LAD, LightLab .014” ImageWire(Renu Virmani, MD, AFIP)

Precision Imaging

Core

Thrombus

Core

Precision Imaging

OCT Cine PullbackHuman Cadaver Circumflex Artery

Thin Capped LesionsThin Capped Lesions

Precision Imaging

Pull-back in stent Pull-back in stent (note early side branch)(note early side branch)

In-vivo Human In-vivo Human

.014” ImageWire

Prof. Eberhard Grube, Siegburg Heart Center

Precision Imaging

In-vivo Human Lesion 400 micrometer capIn-vivo Human Lesion 400 micrometer cap

.014” ImageWire

Prof. Eberhard Grube, Siegburg Heart Center

Bringing a microscope into the Bringing a microscope into the coronaries improves the clinicians ability coronaries improves the clinicians ability to:to:

Select the appropriate therapy

Titrate the delivery of specific therapies

Direct the delivery to targeted lesions

Develop entire new therapeutic approaches

Precision Therapy .

Imaging BalloonImaging Balloon

In-vivo pig, LightLab Imaging Balloon, 3mm and .014” ImageWire – No Flush

Brigham&Women’s Hospital ECI Lab

Real-time inflation visualization

Precision Therapy

Stent and ThrombiStent and Thrombi

Full Screen

In-vivo pig, LightLab .014” ImageWireDr. Campbell Rogers, Brigham&Women’s Hospital ECI Lab

Precision Therapy

Zoom

In-vivo Human Stent in StentIn-vivo Human Stent in Stent

.014” ImageWire

Prof. Eberhard Grube, Siegburg Heart Center

Precision Therapy

Upgrades• Polarization Imaging• Spectroscopic Imaging• Doppler• Elastography

LightLab Imaging Platform – Future LightLab Imaging Platform – Future

(Pending 510(k) Clearance)

LightLab OCT Technology

Sub selective flush Forward looking lens designs

Integrated therapeutic catheters

Imaging System

Catheters

Polarization

Information for a better understanding of Information for a better understanding of microanatomic plaque characteristicsmicroanatomic plaque characteristics

Evaluate plaque

structure and

orderliness

Grey Scale

Detailed

Morphological understanding

Cap thickness, identify fissures, calcium, lipid

Cap/plaque Fiber

Spectroscopy

Determine chemical content

of visualized lesions

Lipid concentration

Polarization

LightLab OCT Technology

Different tissues exhibit different Different tissues exhibit different polarization effectspolarization effects

OCT is inherently sensitive to changes in the polarization of the probe beam.

Birefringence is the major source of contrast in polarization-sensitive OCT imaging.

Very High

Very low

Media (healthy)

Cholesterol crystals

Soft (lipid) plaque

Fibrotic plaque

Intima (healthy)

Calcified plaque

Structure

Bir

efri

ngen

ce

LightLab OCT Technology

Grayscale Polarization Difference

Table Surface

Laminated Structure

LightLab OCT Technology

(Birefringent)

(Non-Birefringent)

Polarization helps differentiate organized Polarization helps differentiate organized (linear) from disorganized structures(linear) from disorganized structures

Magnitude

Polarization

Combined

Grey scale and polarization information may be Grey scale and polarization information may be combined to localize and identify tissue combined to localize and identify tissue characteristicscharacteristics

Platform FuturesPlatform Futures

Polarization

Evaluate plaque

structure and

orderliness

Grey Scale

Detailed

Morphological understanding

Cap thickness, identify fissures, calcium, lipid

Cap/plaque Fiber

Spectroscopy

Determine chemical content

of visualized lesions

Lipid concentration

Polarization

LightLab OCT Technology

Information for a better understanding of Information for a better understanding of microanatomic plaque characteristicsmicroanatomic plaque characteristics

Lipid imaging in phantom

Spectroscopic image

Lipid+calcium Protein+calcium

Gray-scale image

Lipid+calcium Protein+calcium

OCT Spectroscopy identifies differences in composition

LightLab OCT Technology

Today’s Today’s State-of-the-artState-of-the-artOptical Optical Coherence Coherence TomographyTomography

100µm

In vivo 1µm OCT

(Image Courtesy of J. Fujimoto, MIT)

The Future of OCT Imaging

Changing the way you see things.