Molecular imaging of inflammation and intraplaque vasa vasorum: a step forward to identification of vulnerable plaques?
Current developments in cardiovascular biology and imaging enable the noninvasive molecular evaluation of atherosclerotic vascular disease. Intraplaque neovascularization sprouting from the adventitial vasa vasorum has been identified as an independent predictor of intraplaque hemorrhage and plaque rupture. These intraplaque vasa vasorum result from angiogenesis, most likely under influence of hypoxic and inflammatory stimuli. Several molecular imaging techniques are currently available. Most experience has been obtained with molecular imaging using positron emission tomography and single photon emission computed tomography. Recently, the development of targeted contrast agents has allowed molecular imaging with magnetic resonance imaging, ultrasound and computed tomography. The present review discusses the use of these molecular imaging techniques to identify inflammation and intraplaque vasa vasorum to identify vulnerable atherosclerotic plaques at risk of rupture and thrombosis. The available literature on molecular imaging techniques and molecular targets associated with inflammation and angiogenesis is discussed, and the clinical applications of molecular cardiovascular imaging and the use of molecular techniques for local drug delivery are addressed.
ten Kate
Gerrit L
GL
Division of Pharmacology, Vascular and Metabolic Diseases, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.
Sijbrands
Eric J G
EJ
Valkema
Roelf
R
ten Cate
Folkert J
FJ
Feinstein
Steven B
SB
van der Steen
Antonius F W
AF
Daemen
Mat J A P
MJ
Schinkel
Arend F L
AF
D000818:Animals; D016503:Drug Delivery Systems; D006801:Humans; D007249:Inflammation / Q000175:diagnosis* / Q000378:metabolism; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D045423:Microbubbles; D057054:Molecular Imaging / Q000379:methods*; D018919:Neovascularization, Physiologic; D058226:Plaque, Atherosclerotic / Q000175:diagnosis*; D049268:Positron-Emission Tomography; D019087:Selectins / Q000378:metabolism; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D014651:Vasa Vasorum / Q000473:pathology* / Q000502:physiology
D019087:Selectins; D018799:Intercellular Adhesion Molecule-1