Detection of lipid-laden atherosclerotic plaque by wavelet analysis of radiofrequency intravascular ultrasound signals: in vitro validation and preliminary in vivo application.

OBJECTIVES This study examined the feasibility of using a wavelet analysis of radiofrequency (RF) intravascular ultrasound (IVUS) signals in detecting lipid-laden plaque. BACKGROUND Wavelet analysis is a new mathematical model for assessing local changes in a geometrical profile of time-series signals. METHODS Radiofrequency IVUS signals of 85 arbitrarily selected vectors were acquired from 27 formalin-fixed noncalcified atherosclerotic plaques from human necropsy with a digitizer at 500 MHz with 8-bit resolution by use of a 40-MHz IVUS catheter. Wavelet analysis of these RF signals was performed using a Daubechies-2 wavelet to obtain a color-coded map of the correlation coefficient with the wavelet reconstructed over the x-y plane of the wavelet scale and the distance from the IVUS catheter. The plaque segment was then examined histologically after being stained with Masson's trichrome stain. This technique also was applied in vivo in 29 human coronary plaque segments. These segments were excised subsequently by directional coronary atherectomy and processed for histologic analysis. RESULTS In the in vitro study, histologic examination revealed lipid-laden segments in 29 vectors. When performing a wavelet analysis with the Daubechies-2 wavelet, the color-coded mapping revealed a different pattern in lipid-laden plaques compared with other types of plaque. Using this wavelet analysis, lipid-laden plaque could be detected with a sensitivity of 83% (24 of 29) and a specificity of 82% (46 of 56). In the in vivo study, fatty plaque could be detected with a sensitivity of 81% (13 of 16) and a specificity of 85% (11 of 13) with this method. CONCLUSIONS Wavelet analysis of RF IVUS signals enabled in vitro as well as in vivo detection of lipid-laden plaque. This method may be useful in assessing plaque vulnerability in patients with coronary artery disease.