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Neurol Med Chir (Tokyo). 2019 Feb 28. doi: 10.2176/nmc.oa.2018-0203. [Epub ahead of print]

Ex Vivo Assessment of Various Histological Differentiation in Human Carotid Plaque with Near-infrared Spectroscopy Using Multiple Wavelengths.

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Department of Neurosurgery, Kyoto University.
Department of Neurosurgery, Shiga General Hospital.
Department of Electronics and Electrical Engineering, Keio University.
Department of Neurosurgery, Kokura Memorial Hospital.
Department of Neurosurgery, National Cerebral and Cardiovascular Center.
Department of Neurosurgery, Tokushima University.


We previously reported that near-infrared hyperspectral imaging enabled the localization of atherosclerotic plaques from outside the vessels, but not the optical characteristics of each histological component. Therefore, the near-infrared spectrum of each component was collected from the sliced section of the human carotid plaque obtained with endarterectomy and the optical characteristics were confirmed in several wavelengths. Based on this information, we assessed the diagnostic accuracy for ex vivo chemogram in each plaque component created with near-infrared spectroscopy (NIRS), using multiple wavelengths. The chemogram projected on the actual image of plaque was created based on light intensity and transmittance change at three wavelengths. The wavelengths that were mainly were 1440, 1620, 1730, and 1930 nm. We evaluated the accuracy of histological diagnosis in chemogram compared with pathological findings, analyzing interobserver agreement with κ-statistics. The chemograms that we created depicted the components of fibrous tissue, smooth muscle, lipid tissue, intraplaque hemorrhage, and calcification. Diagnostic odds ratio in each component was as follows: 259.6 in fibrous tissue, 144 in smooth muscle, 1123.5 in lipid tissue, 29.3 in intraplaque hemorrhage, and 136.3 in calcification. The κ-statistics revealed that four components, excluding intraplaque hemorrhage, had substantial or almost perfect agreement. Thus, this study demonstrated the feasibility of using chemogram focused on specific component during the histological assessment of atherosclerotic plaques, highlighting its potential diagnostic ability. Chemograms of various target components can be created by combining multiple wavelengths. This technology may prove to be useful in improving the histological assessment of plaque using NIRS.


atherosclerosis; carotid artery stenosis; carotid plaque; near infrared spectroscopy; plaque imaging

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