Acute coronary syndrome (ACS) is a common cardiovascular event with significant implications on global health. Degradation and remodelling of coronary plaques play a pivotal role in both the development of ACS, which can be visualized using intravascular PS-OCT, a high resolution, invasive imaging modality with contrast for collagen. In this work we adapt a machine-learning based segmentation pipeline to enable volumetric assessment of coronary plaques and automated evaluation of polarization properties. The utility of this framework is demonstrated through a case study investigating the fibrous caps of coronary plaques between unstable patients with ACS and stable patients with chronic coronary syndrome (CCS). Preliminary results show that ACS plaque caps exhibit significantly lower birefringence than the caps of lesions in CCS patients, while having comparable cap thickness. Our pipeline allows for automated volumetric coronary plaque analysis, paving the way toward prospective studies to determine whether volumetric properties measured with intravascular PS-OCT may improve risk stratification of patients with coronary artery disease.
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