Molecular Imaging of Vulnerable Coronary Plaque: A Pathophysiologic Perspective.
Atherothrombotic events in coronary arteries are most often due to rupture of unstable plaque resulting in myocardial infarction. Radiolabeled molecular imaging tracers directed toward cellular targets that are unique to unstable plaque can serve as a powerful tool for identifying high-risk patients and for assessing the potential of new therapeutic approaches. Two commonly available radiopharmaceuticals-18F-FDG and18F-NaF-have been used in clinical research for imaging coronary artery plaque, and ongoing clinical studies are testing whether there is an association between18F-NaF uptake and future atherothrombotic events. Other, less available, tracers that target macrophages, endothelial cells, and apoptotic cells have also been tested in small groups of patients. Adoption of molecular imaging of coronary plaque into clinical practice will depend on overcoming major hurdles, ultimately including evidence that the detection of unstable plaque can change patient management and improve outcomes.
Cedars-Sinai Medical Center, Los Angeles, California.
Sandeep
S
Krishnan
Cedars-Sinai Medical Center, Los Angeles, California.
Yuka
Y
Otaki
Cedars-Sinai Medical Center, Los Angeles, California.
Mhairi
M
Doris
Cedars-Sinai Medical Center, Los Angeles, California.
Leandro
L
Slipczuk
Cedars-Sinai Medical Center, Los Angeles, California.
Yoav
Y
Arnson
Cedars-Sinai Medical Center, Los Angeles, California.
Mathieu
M
Rubeaux
Cedars-Sinai Medical Center, Los Angeles, California.
Damini
D
Dey
Cedars-Sinai Medical Center, Los Angeles, California.
Piotr
P
Slomka
Cedars-Sinai Medical Center, Los Angeles, California.
Daniel S
DS
Berman
Cedars-Sinai Medical Center, Los Angeles, California balaji.tamarappoo@cshs.org.
Balaji
B
Tamarappoo
D015415:Biomarkers / Q000378:metabolism; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000378:metabolism*; D019317:Evidence-Based Medicine; D006801:Humans; D057054:Molecular Imaging / Q000379:methods*; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000378:metabolism*; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*
D015415:Biomarkers; D019275:Radiopharmaceuticals
PET; angiogenesis; atherosclerosis; cardiology; inflammation; molecular imaging