Review of Optical Imaging in Coronary Artery Disease Diagnosis

Naeif Almagal ^1 2, Niall Leahy ¹, Foziyah Alqahtani ^1 3, Sara Alsubai ^1 3, Hesham Elzomor ¹, Paolo Alberto Del Sole ¹, Ruth Sharif ¹, Faisal Sharif ¹

Affiliations Expand

• PMID: 40863354
• PMCID: PMC12386230
• DOI: 10.3390/jcdd12080288

Abstract

Optical Coherence Tomography (OCT) is a further light-based intravascular imaging modality and provides a high-resolution, cross-sectional view of coronary arteries. It has a useful anatomic and increasingly physiological evaluation in light of coronary artery disease (CAD). This review provides a critical examination of the increased application of the OCT in assessing coronary artery physiology, beyond its initial mainstay application in anatomical imaging. OCT provides precise information on plaque morphology, which can help identify vulnerable plaques, and is most important in informing percutaneous coronary interventions (PCIs), including implanting a stent and optimizing it. The combination of OCT and functional measurements, such as optical flow ratio and OCT-based fractional flow reserve (OCT-FFR), permits a more complete assessment of coronary stenoses, which may provide increased diagnostic accuracy and better revascularization decision-making. The recent developments in OCT technology have also enhanced the accuracy in the measurement of coronary functions. The innovations may support the optimal treatment of patients as they provide more personalized and individualized treatment options; however, it is critical to recognize the limitations of OCT and distinguish between the hypothetical advantages and empirical outcomes. This review evaluates the existing uses, technological solutions, and future trends in OCT-based physiological imaging and evaluation, and explains how such an advancement will be beneficial in the treatment of CAD and gives a fair representation concerning other imaging applications.

Keywords: OCT-based FFR; coronary artery disease (CAD); coronary imaging; fractional flow reserve (FFR); intravascular ultrasound (IVUS); optical coherence tomography (OCT); plaque morphology.

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Conflict of interest statement

The authors declare no conflict of interest.

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