Aging of deep venous thrombosis in-vivo using polarization sensitive optical coherence tomography.

Autor: Jones GL; Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.; Harvard Medical School and Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA., Albadawi H; Division of Vascular and Interventional Radiology, Mayo Clinic, Scottsdale, AZ 85259, USA., Hariri LP; Harvard Medical School and Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA.; Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA 02114, USA.; Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA., Bouma BE; Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.; Harvard Medical School and Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA., Oklu R; Division of Vascular and Interventional Radiology, Mayo Clinic, Scottsdale, AZ 85259, USA., Villiger M; Harvard Medical School and Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA.
Jazyk: angličtina
Zdroj: Biomedical optics express [Biomed Opt Express] 2024 May 03; Vol. 15 (6), pp. 3627-3638. Date of Electronic Publication: 2024 May 03 (Print Publication: 2024).
DOI: 10.1364/BOE.522238
Abstrakt: Deep venous thrombosis (DVT) is a medical condition with significant post-event morbidity and mortality coupled with limited treatment options. Treatment strategy and efficacy are highly dependent on the structural composition of the thrombus, which evolves over time from initial formation and is currently unevaluable with standard clinical testing. Here, we investigate the use of intravascular polarization-sensitive optical coherence tomography (PS-OCT) to assess thrombus morphology and composition in a rat DVT model in-vivo , including changes that occur over the thrombus aging process. PS-OCT measures tissue birefringence, which provides contrast for collagen and smooth muscle cells that are present in older, chronic clots. Thrombi in the inferior vena cava of two cohorts of rats were imaged in-vivo with intravascular PS-OCT at 24 hours (acute, n rats  = 3, 73 cross-sections) or 28 days (chronic, n rats  = 4, 41 cross-sections) after thrombus formation. Co-registered histology was labelled by an independent pathologist to establish ground-truth clot composition. Automated analysis of OCT cross-sectional images differentiated acute and chronic thrombi with 97.6% sensitivity and 98.6% specificity using a linear discriminant model comprised of both polarization and conventional OCT metrics. These results support PS-OCT as a highly sensitive imaging modality for the assessment of DVT composition to differentiate acute and chronic thrombi. Intravascular PS-OCT imaging could be integrated with advanced catheter-based treatment strategies and serve to guide therapeutic decision-making and deployment, by offering an accurate assessment of DVT patients in real time.
Competing Interests: Massachusetts General Hospital have patent licensing arrangements with Terumo Corporation. Dr. Bouma and Dr. Villiger have the right to receive royalties as part of the patent licensing arrangements with Terumo Corporation. Dr. Bouma has a financial interest in Soleron Imaging, LLC, a seller of unique optical imaging instruments and components used in this research. Dr. Bouma’s interests were reviewed and are managed by Massachusetts General Hospital and Mass General Brigham in accordance with their conflict-of-interest policies. Dr. Hariri reports grants from Boehringer Ingelheim Pharmaceuticals Inc (BIPI) and has received personal consulting fees from BIPI, Pliant Therapeutics, Clario and Abbvie Pharmaceuticals.
(© 2024 Optica Publishing Group.)
Databáze: MEDLINE
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