title: Emerging approaches for imaging vulnerable plaques in patients.
abstract: The diagnosis of vulnerable plaques, which have the propensity to develop atherothrombosis, remains an elusive goal in clinical medicine. The most accepted features of vulnerable plaques, such as a large lipid core, increased inflammatory milieu and thin fibrous caps, have been well characterized through pathological studies. The ability to image a vulnerable plaque in susceptible patients would theoretically result in useful prognostic information that can be used to either monitor or treat patients at risk more aggressively. Several invasive techniques, such as integrated backscatter, virtual histology, palpography, optical coherence tomography and thermal heterogeneity, have been validated ex vivo and are now being evaluated in clinical studies. Non-invasive techniques, such as nuclear imaging, show promise in identifying increased metabolic activity and characteristic features of vulnerable plaques in patients. Natural history and intervention studies will need to be performed to determine whether identifying and treating vulnerable plaques will lead to improved clinical outcomes.
authors.affiliation: Division of Cardiology, University of California San Diego, La Jolla, USA.
authors.forename: Seung-Hyuk
authors.initials: SH
authors.lastname: Choi
authors.forename: Andrew
authors.initials: A
authors.lastname: Chae
authors.forename: Cheng Han
authors.initials: CH
authors.lastname: Chen
authors.forename: Esther
authors.initials: E
authors.lastname: Merki
authors.forename: Peter X
authors.initials: PX
authors.lastname: Shaw
authors.forename: Sotirios
authors.initials: S
authors.lastname: Tsimikas
mesh_terms: D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D006801:Humans; D049268:Positron-Emission Tomography; D015899:Tomography, Emission-Computed, Single-Photon; D041623:Tomography, Optical Coherence; D018084:Ultrasonography, Interventional