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Ultra-high-speed Intracoronary Imaging within a Single Heart Beat

The fastest three-dimensional high-resolution intracoronary endoscopy, opening up a new horizon of cardiovascular disease diagnosis

“Intravascular Optical Coherence Tomography (OCT) provides imaging of three-dimensional microstructure of the vessel wall, accurately diagnosing cardiovascular diseases. In order to acquire images of the inside of the vessels, the images have to be taken endoscopically in a couple of seconds immediately after the blood clearing through transparent fluid injection into the vessel. Yet the imaging speed of the existing system is rather slow; as a consequence, images are taken sparsely, resulting in inaccurate diagnosis. The ‘Ultra-high-speed intracoronary imaging within a single heart beat’, however, is able to take 500 images per second of the interior of blood vessels. The fastest and high-resolution intracoronary OCT technique provides visualization of long coronary artery in full detail. This technique is expected to significantly increase the accuracy of the diagnosis for cardiovascular diseases going forward.”

Ultra-high-speed intracoronary imaging system taking 500 images per second, significantly increasing the accuracy of cardiovascular disease diagnosis

Most acute myocardial infarction cases are fatal. Normally, the heart muscles get oxygen from the blood flow in coronary arteries, but when the coronary artery narrows to the point of blocking the blood flow, the oxygen is not properly provided to the heart muscles, leading to a sudden stoppage of the heartbeat and, ultimately, death. Therefore early diagnosis of coronary artery diseases based on accurate imaging is essential.

Since the x-ray-based angiography or the intravascular ultrasound, which have been the standard diagnostic imaging tools for the intravascular diseases, have limitation in accurate identification of conditions of the vessels due to their poor resolution, doctors are showing great interest in the new ultra-high-speed and high-resolution intravascular imaging technique.

Against this backdrop, Professor Oh, Wang-Yuhl and his team have continuously conducted the development of ultra-high-speed and high-resolution intracoronary imaging system in close cooperation with hospitals. In 2014, the team successfully took comprehensive images of a 7-centimeter-long aorta of a rabbit at a rate of 350 images per second. In 2015, the team took images of the coronary artery of a pig, which is known to have a similar vessel size with that of humans, with a speed of 500 images per second. This is the fastest high-resolution imaging technology in the world.

The human heart beats approximately once a second, so there are 4 to 5 heartbeats occurring during the about 5 seconds imaging time of conventional intravascular OCT technique. These heartbeats significantly distort the image quality due to the motion created by the contraction and expansion of the vessel during imaging. Therefore, it is sometimes hard to tell if the vessel actually narrows or if there is just an ‘artifact’ (a phenomenon where conditions that do not really exist or false images are observed due to errors in the imaging). Since the currently fastest intracoronary OCT takes images for 3 to 5 seconds at the imaging speed of 100 to 180 frames per second, there is a risk of inaccurate diagnosis due to the motion-induced artifacts in images.

The ‘Ultra-high speed intracoronary imaging within a single heart beat’ is a core technique that could resolve such limitationa. Since it automatically identifies the short moment within a single heart beat having the minimal motion and takes ultra-high-speed imaging at a rate of 500 images per second, it provides high-resolution pictures of the interior of the blood vessels without distortions.

Professor Oh and his team successfully took the images of the coronary artery of a pig’s heart, the size of which was similar to that of a human, in collaboration with Professor Kim, Jin Won’s team at the Korea University Guro Hospital. This technique is now in the preparatory process for the KFDA approval. This study is highly acclaimed as a revolutionary advancement in the medical diagnosis field and is expected to be applied to various areas requiring three-dimensional cardiovascular OCT imaging, such as cardiovascular plaque shape analysis and stent (a fine tube used to keep the vessel open) insertion.

Prof. Oh, Wang-Yuhl
2015 Annual Report

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