Optimisation of post mortem cardiac computed tomography compared to optical coherence tomography and histopathology – Technical note

IntroductionCoronary atherosclerosis is a leading cause of mortality. New technological developments in computed tomography (CT), including dual energy, iterative reconstructions and high definition scanning, could significantly improve the non-invasive identification of atherosclerosis plaques. Here, a new method for optimising cardiac coronary CT with optical coherence tomography (OCT) and histopathology is presented.Materials and methodsTwenty human hearts obtained from autopsies were used. A contrast agent that solidifies after cooling was injected into the coronary arteries. CT scanning was performed on the heart alone as well as with the heart in a chest phantom. We used eight different CT protocols and the newest CT technique to image every heart. The OCT and CT images were compared with their corresponding histological sections. A procedure for ensuring the correct alignment of the images was also developed.ResultsWe have succeeded in developing a new method for post-mortem coronary CT angiography in which an autopsy heart is placed in a chest phantom to simulate clinical CT.ConclusionThe new method permits comparison of CT with OCT and histopathology. This method can also be used for evaluating coronary artery disease, including characterising plaques, and will eventually allow for the detection of rupture-prone plaques, which we will assess in a future study. Clinical testing is our ultimate goal.