(18)F-fluorodeoxyglucose PET imaging of coronary atherosclerosis and plaque inflammation

The emphasis of current cardiovascular imaging modalities is on the anatomic detection of coronary artery luminal narrowing. However, in the clinical setting, vulnerable plaques that are not flow limiting may account for the majority of cardiovascular events. Thus, the pursuit for developing noninvasive imaging techniques that target vulnerable plaques is a laudable goal. Recent studies have demonstrated the clinical feasibility of direct visualization and characterization of coronary and carotid artery plaques with (18)F-fluorodeoxyglucose (FDG) positron emission tomography imaging. In experimental studies, the intensity of FDG uptake has been shown to correlate with macrophage density and inflammatory state of plaques. Vascular plaque FDG uptake has been linked to cardiovascular events such as myocardial infarction and stroke. Anti-inflammatory drugs and statins have been shown to attenuate FDG uptake in plaques. Thus, the identification of FDG uptake in vascular plaques may have important clinical implications for predicting and preventing future cardiovascular events.