PET Imaging of Atherosclerosis

ABSTRACT 

Atherosclerosis is a chronic, progressive, multifocal disease of the arterial wall, which is mainly fuelled by local and systemic inflammation, often resulting in acute ischemic events following plaque rupture and vessel occlusion. When assessing the cardiovascular risk of an individual patient, we must consider both global measures of disease activity and local features of plaque vulnerability, in addition to anatomical distribution and degree of established atherosclerosis. These parameters cannot be measured with conventional anatomical imaging techniques alone, which are designed primarily to identify the presence of organic intraluminal obstruction in symptomatic patients. However, molecular imaging with PET, using specifically targeted radiolabeled probes to track active in vivo atherosclerotic mechanisms noninvasively, may potentially provide a method that is better suited for this purpose. Vascular PET imaging can help us to further understand aspects of plaque biology, and current evidence supports a future role as an emerging clinical tool for the quantification of cardiovascular risk in order to guide and monitor responses to antiatherosclerosis treatments and to distinguish high-risk plaques.

KEYWORDS :

• ¹⁸F-fluorodeoxyglucose
• positron emission tomography
• atherosclerosis
• inflammation
• molecular imaging
• vulnerable plaque

Financial & competing interests disclosure

JM Tarkin, FR Joshi and JHF Rudd are supported by the National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre. JM Tarkin is supported by a Wellcome Trust research training fellowship. FR Joshi is supported by a British Heart Foundation Clinical Research Fellowship and a Raymond and Beverley Sackler PhD Studentship. JHF Rudd is supported by the British Heart Foundation, the Evelyn Trust and the Academy of Medical Sciences. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.