Molecular imaging in atherosclerosis.

Area of Science:

• Cardiovascular Medicine
• Medical Imaging
• Pathobiology

Background:

• Atherosclerosis is a primary cause of cardiovascular disease, leading to significant morbidity and mortality.
• Disease development involves multiple risk factors and pathobiological processes, resulting in distinct plaque remodeling stages.
• Emerging research highlights inflammation's crucial role alongside lipids in all atherosclerosis stages.

Purpose of the Study:

• To review the different stages of atherosclerosis and their clinical relevance.
• To describe the molecular events underlying atherosclerosis development.
• To discuss various imaging modalities for assessing atherosclerotic plaques across disease stages.

Main Methods:

• Review of non-nuclear invasive imaging techniques (e.g., intravascular ultrasound, OCT).
• Review of non-nuclear non-invasive imaging techniques (e.g., CT angiography, MRI).
• Focus on nuclear imaging techniques for plaque components, inflammation, and thrombosis.

Main Results:

• Non-nuclear imaging provides anatomical and physiological insights into atherosclerotic plaques.
• Nuclear imaging offers functional information on plaque activity, potentially improving event prediction.
• Current nuclear imaging lacks a definitive tracer for predicting stroke or infarction.

Conclusions:

• Atherosclerosis is a complex inflammatory and lipid-driven disease.
• Advanced imaging, especially nuclear techniques, is crucial for understanding plaque biology and progression.
• Future development of targeted nuclear tracers could revolutionize diagnosis and therapy for cardiovascular disease.