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Related Concept Videos

Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT01:25

Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT

Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Related Experiment Video

Updated: Jun 21, 2026

In vivo Near Infrared Fluorescence (NIRF) Intravascular Molecular Imaging of Inflammatory Plaque, a Multimodal Approach to Imaging of Atherosclerosis
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In vivo Near Infrared Fluorescence (NIRF) Intravascular Molecular Imaging of Inflammatory Plaque, a Multimodal Approach to Imaging of Atherosclerosis

Published on: August 4, 2011

Current status of vulnerable plaque detection.

Faisal Sharif1, Ross T Murphy

  • 1Department of Cardiology, St James' Hospital, St James' Street, Dublin 8, Ireland. faisalshareef@yahoo.com

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|August 12, 2009
PubMed
Summary

Identifying vulnerable plaques in coronary artery disease remains challenging. While imaging shows promise, physiological assessment with fractional flow reserve is key for managing non-flow-limiting stenoses.

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In vivo Near Infrared Fluorescence (NIRF) Intravascular Molecular Imaging of Inflammatory Plaque, a Multimodal Approach to Imaging of Atherosclerosis
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Quantification of Atherosclerotic Plaque Activity and Vascular Inflammation using [18-F] Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT)
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Published on: May 2, 2012

Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology
  • Biomarkers of Atherosclerosis

Background:

  • Acute coronary syndromes (ACS) and sudden cardiac death are often linked to vulnerable plaques, not just critical stenoses.
  • Autopsy studies reveal high-risk patients with disrupted vulnerable plaques and modest stenosis, highlighting a clinical need for prospective identification.
  • Current imaging modalities struggle to definitively identify vulnerable plaques and predict outcomes.

Purpose of the Study:

  • To review current and emerging imaging techniques for identifying high-risk vulnerable plaques in coronary artery disease.
  • To discuss the potential of physiological assessment in managing patients with advanced atherosclerotic disease.
  • To emphasize the need for further research into plaque natural history and targeted therapies.

Main Methods:

  • Review of invasive imaging techniques: angioscopy, intravascular ultrasound, intravascular MRI, optical coherence tomography, intravascular thermography, and spectroscopy.
  • Discussion of noninvasive imaging modalities: MRI, CT, and PET.
  • Analysis of physiological assessment using fractional flow reserve (FFR).

Main Results:

  • Anatomical features of vulnerable plaques (thin cap, lipid pool) can be identified by various imaging techniques.
  • Inflammation and chemical composition are emerging targets for plaque characterization.
  • Fractional flow reserve (FFR) trials show deferral of percutaneous coronary intervention (PCI) with optimal medical therapy is superior for modest non-flow-limiting stenoses.

Conclusions:

  • No current imaging modality definitively detects vulnerable plaque or predicts outcomes.
  • Physiological assessment, particularly FFR, offers a valuable approach for managing patients with non-flow-limiting coronary stenoses.
  • Further trials are essential to understand the natural history of high-risk plaques and refine patient-specific therapies and plaque stabilization strategies.