Molecular Imaging of Vulnerable Coronary Plaque: A Pathophysiologic Perspective

Area of Science:

• Cardiovascular Imaging
• Molecular Imaging
• Radiopharmaceuticals

Background:

• Atherothrombotic events, such as myocardial infarction, often result from unstable coronary plaque rupture.
• Molecular imaging tracers targeting unique unstable plaque components offer a tool for risk stratification and therapeutic assessment.

Purpose of the Study:

• To review the role of molecular imaging in identifying unstable coronary plaque.
• To discuss the potential of radiolabeled tracers in patient management and outcome prediction.

Main Methods:

• Utilized commonly available radiopharmaceuticals like 18F-FDG and 18F-NaF for coronary plaque imaging.
• Reviewed clinical studies investigating tracers targeting macrophages, endothelial cells, and apoptotic cells.

Main Results:

• Ongoing studies explore the association between 18F-NaF uptake and future atherothrombotic events.
• Various targeted tracers have shown promise in small patient cohorts.

Conclusions:

• Molecular imaging holds potential for identifying high-risk patients with unstable coronary plaque.
• Clinical adoption requires demonstrating improved patient management and outcomes through plaque detection.