Vulnerable plaque imaging using ¹⁸F-sodium fluoride positron emission tomography

Area of Science:

• Cardiovascular Imaging
• Nuclear Medicine
• Radiochemistry

Background:

• Atherosclerotic plaques pose a significant risk for cardiovascular events.
• Current imaging methods primarily assess plaque burden, not activity.
• Microcalcification is a marker of vulnerable plaques.

Purpose of the Study:

• To review the utility of ¹⁸F-sodium fluoride (¹⁸F-NaF) Positron Emission Tomography (PET) in imaging atherosclerosis.
• To explore the association between ¹⁸F-NaF uptake and traditional coronary artery disease risk factors.
• To evaluate the correlation of ¹⁸F-NaF uptake with plaque morphology and histological findings.

Main Methods:

• Review of studies utilizing ¹⁸F-NaF PET for atherosclerosis imaging.
• Analysis of associations between ¹⁸F-NaF uptake, risk factors, and plaque characteristics.
• Inclusion of histological and intravascular/CT imaging validation data.

Main Results:

• ¹⁸F-NaF PET visualizes microcalcifications in atherosclerotic plaques.
• ¹⁸F-NaF uptake correlates with plaque activity and morphology.
• Associations between ¹⁸F-NaF uptake and traditional CAD risk factors are being established.

Conclusions:

• ¹⁸F-NaF PET is a promising non-invasive tool for identifying high-risk and ruptured atherosclerotic plaques.
• This imaging modality may enhance the evaluation of coronary artery disease by assessing plaque activity.
• Further research and technical advancements are needed for widespread clinical application.