New methods to image unstable atherosclerotic plaques

Area of Science:

• Cardiovascular Imaging
• Biomedical Engineering
• Radiology

Background:

• Atherosclerotic plaque rupture causes myocardial infarction and stroke, leading global mortality.
• Accurate prediction of these events is challenging due to the rarity of individual occurrences despite widespread atherosclerosis.
• Current imaging methods assess plaque morphology, but integrating functional data is crucial.

Purpose of the Study:

• To review advanced imaging techniques for assessing atherosclerotic plaque characteristics.
• To explore the potential of hybrid PET-CT and PET-MR in evaluating plaque biology.
• To discuss how these methods can redefine risk prediction and therapy allocation for coronary artery disease.

Main Methods:

• Computed Tomography (CT) and Magnetic Resonance (MR) imaging for plaque morphology and characteristics.
• Positron Emission Tomography (PET) imaging for measuring pathological processes and disease activity.
• Hybrid integration of PET with CT or MR for comprehensive plaque assessment.

Main Results:

• CT and MR can identify unstable plaque features linked to rupture risk.
• PET imaging differentiates active from inactive atherosclerotic disease states.
• Hybrid PET-CT/MR enables assessment of plaque burden, morphology, and biology.

Conclusions:

• Advanced imaging, particularly hybrid PET-CT/MR, promises to enhance understanding of coronary artery disease.
• These techniques may refine patient risk stratification beyond traditional symptomatic evaluation.
• Improved risk prediction can guide the allocation of novel, expensive therapies more effectively.