Deep learning-based plaque characterization in hybrid IVUS-OCT images is superior to single-modality deep learning analysis and human experts: head-to-head comparison against histology.
Publisher DOI
PubMed ID
41603422
Abstract
Aims
Hybrid intravascular ultrasound-optical coherence tomography (IVUS-OCT) can enable more accurate plaque characterization than single-modality intravascular imaging, enhancing treatment planning and vulnerable plaque detection. However, image interpretation in IVUS-OCT is challenging and time-consuming. To overcome this limitation, we introduce a novel histology-trained deep learning (DL)-classifier for plaque component classification in IVUS-OCT images and compare its performance against single-modality DL and expert analysts.Methods And Results
IVUS-OCT frames and matched histological sections from 10 cadaveric human hearts were included in this analysis. The histological data were used to define fibrotic, calcific, and necrotic core tissue regions of interest (ROIs) in IVUS-OCT and used to train three DL-classifiers for IVUS, OCT, or hybrid IVUS-OCT image analysis (992 frames) and test their performance (264 frames). The test set was additionally annotated by experts from three different core labs, and their estimations and those of the DL-classifiers were compared with histology.The IVUS-OCT DL-classifier had a superior performance to the IVUS-DL, OCT-DL, and the expert analysts in detecting plaque phenotypes (Kappa 0.60 vs. 0.19, 0.35, and 0.53, respectively) and accurately classified 68% of histologically defined fibroatheromas. The hybrid IVUS-OCT DL-classifier also had a better performance than single-modality DL-classifiers and the experts in assessing tissue types in ROIs annotated by histology (overall accuracy 86.7% compared with 73.2% for IVUS-DL, 66.6% for OCT-DL, and 70.6% for the experts).Conclusion
Plaque characterization using a histology-trained hybrid IVUS-OCT DL-classifier is feasible and enables more accurate detection of plaque components and phenotype classification than single-modality DL-classifiers and expert analysts.
Hybrid intravascular ultrasound-optical coherence tomography (IVUS-OCT) can enable more accurate plaque characterization than single-modality intravascular imaging, enhancing treatment planning and vulnerable plaque detection. However, image interpretation in IVUS-OCT is challenging and time-consuming. To overcome this limitation, we introduce a novel histology-trained deep learning (DL)-classifier for plaque component classification in IVUS-OCT images and compare its performance against single-modality DL and expert analysts.Methods And Results
IVUS-OCT frames and matched histological sections from 10 cadaveric human hearts were included in this analysis. The histological data were used to define fibrotic, calcific, and necrotic core tissue regions of interest (ROIs) in IVUS-OCT and used to train three DL-classifiers for IVUS, OCT, or hybrid IVUS-OCT image analysis (992 frames) and test their performance (264 frames). The test set was additionally annotated by experts from three different core labs, and their estimations and those of the DL-classifiers were compared with histology.The IVUS-OCT DL-classifier had a superior performance to the IVUS-DL, OCT-DL, and the expert analysts in detecting plaque phenotypes (Kappa 0.60 vs. 0.19, 0.35, and 0.53, respectively) and accurately classified 68% of histologically defined fibroatheromas. The hybrid IVUS-OCT DL-classifier also had a better performance than single-modality DL-classifiers and the experts in assessing tissue types in ROIs annotated by histology (overall accuracy 86.7% compared with 73.2% for IVUS-DL, 66.6% for OCT-DL, and 70.6% for the experts).Conclusion
Plaque characterization using a histology-trained hybrid IVUS-OCT DL-classifier is feasible and enables more accurate detection of plaque components and phenotype classification than single-modality DL-classifiers and expert analysts.
Date Issued
2026-03-16
Publication Type
Article
Subject(s)
Subjects
Intravascular ultrasound
•
Machine learning
•
Optical coherence tomography
•
Plaque characterization
Language(s)
en
Author(s)
Bajaj, Retesh | |
Huang, Xingru | |
Alves-Kotzev, Natasha | |
Weyers, Jill J | |
Levine, Molly | |
Garg, Mohil | |
Maung, Soe | |
Parasa, Ramya | |
Çap, Murat | |
Torii, Ryo | |
Krams, Rob | |
Butany, Jagdish | |
Mathur, Anthony | |
Baumbach, Andreas | |
Zhang, Qianni | |
Courtney, Brian K | |
Bourantas, Christos V |
Additional Credits
Journal
Cardiovascular Research
Publisher
Oxford University Press
ISSN
1755-3245
0008-6363
Access(Rights)
restricted