Evolving Role of PET in Detecting and Characterizing Atherosclerosis

Cardiovascular molecular imaging has focused on assessing myocardial perfusion and ventricular ejection fraction. These modalities target late downstream effects of the atherosclerotic disease process; this calls for a change of focus toward methods that can detect early arterial wall changes before macrocalcifications become visible on computed tomography angiography and provide a better understanding of the disease process. We summarize current knowledge on PET in atherosclerosis and highlight pertinent questions relating to the early detection of atherosclerosis. The future of PET in atherosclerosis may be early individualized quantification of the arteriosclerotic disease burden rather than exploration of features of individual arterial plaques.