title: Positron emission tomography of the vulnerable atherosclerotic plaque in man--a contemporary review.
abstract: Atherosclerosis is the primary underlying cause of cardiovascular disease (CVD). It is the leading cause of morbidity and mortality in the Western world today and is set to become the prevailing disease and major cause of death worldwide by 2020. In the 1950s surgical intervention was introduced to treat symptomatic patients with high-grade carotid artery stenosis due to atherosclerosis--a procedure known as carotid endarterectomy (CEA). By removing the atherosclerotic plaque from the affected carotid artery of these patients, CEA is beneficial by preventing subsequent ipsilateral ischemic stroke. However, it is known that patients with low to intermediate artery stenosis may still experience ischemic events, leading clinicians to consider plaque composition as an important feature of atherosclerosis. Today molecular imaging can be used for characterization, visualization and quantification of cellular and subcellular physiological processes as they take place in vivo; using this technology we can obtain valuable information on atherosclerostic plaque composition. Applying molecular imaging clinically to atherosclerotic disease therefore has the potential to identify atherosclerotic plaques vulnerable to rupture. This could prove to be an important tool for the selection of patients for CEA surgery in a health system increasingly focused on individualized treatment. This review focuses on current advances and future developments of in vivo atherosclerosis PET imaging in man.
authors.affiliation: Cluster for Molecular Imaging, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Sune F
authors.initials: SF
authors.lastname: Pedersen
authors.forename: Anne Mette F
authors.initials: AM
authors.lastname: Hag
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Klausen
authors.forename: Rasmus S
authors.initials: RS
authors.lastname: Ripa
authors.forename: Rasmus P
authors.initials: RP
authors.lastname: Bodholdt
authors.forename: Andreas
authors.initials: A
authors.lastname: Kjaer
mesh_terms: D000818:Animals; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000601:surgery; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D016894:Endarterectomy, Carotid; D006801:Humans; D018579:Patient Selection; D058226:Plaque, Atherosclerotic; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011379:Prognosis; D019275:Radiopharmaceuticals; D012422:Rupture, Spontaneous; D012720:Severity of Illness Index
chemical_list: D019275:Radiopharmaceuticals
keywords: atherosclerosis; in vivo; molecular imaging; positron emission tomography; vulnerable plaque