Imaging Atherosclerosis

Abstract

Advances in atherosclerosis imaging technology and research have provided a range of diagnostic tools to characterize high-risk plaque in vivo; however, these important vascular imaging methods additionally promise great scientific and translational applications beyond this quest. When combined with conventional anatomic- and hemodynamic-based assessments of disease severity, cross-sectional multimodal imaging incorporating molecular probes and other novel noninvasive techniques can add detailed interrogation of plaque composition, activity, and overall disease burden. In the catheterization laboratory, intravascular imaging provides unparalleled access to the world beneath the plaque surface, allowing tissue characterization and measurement of cap thickness with micrometer spatial resolution. Atherosclerosis imaging captures key data that reveal snapshots into underlying biology, which can test our understanding of fundamental research questions and shape our approach toward patient management. Imaging can also be used to quantify response to therapeutic interventions and ultimately help predict cardiovascular risk. Although there are undeniable barriers to clinical translation, many of these hold-ups might soon be surpassed by rapidly evolving innovations to improve image acquisition, coregistration, motion correction, and reduce radiation exposure. This article provides a comprehensive review of current and experimental atherosclerosis imaging methods and their uses in research and potential for translation to the clinic.

A New Look at Atherosclerosis Repeatable Science Ushers in a New Era of Medicine

“…Screening tests lack sensitivity and specificity; diagnostic tests are expensive, toxic, dangerous and cumbersome and therapies are essentially without important effect and with significant toxicities [58]. Thus have we dealt with the biggest challenge of our time in medicine.…”

The Role of Coronary Computed Tomography Angiography and Cardiac Magnetic Resonance in STEMI Patients with Normal Coronary Angiography

“…20 The determination of plaque composition with the use of CCTA can be challenging due to the influence of various factors, including the size of the necrotic area, the lumen thickness, the density of the intraluminal contrast medium, slice thickness, and reconstruction filters. 21 One of the most important advantages of coronary MR angiography over cardiac CT is that it does not expose the examined subject to radiations. A study proved that CCTA is not very accurate in diagnosing heavily calcified plaques.…”

“…Another important advantage of CMR is the lack of using contrast agents. 21,22 CONCLUsIONs Even if invasive coronary angiography is one of the most accurate methods for the diagnosis and treatment of myocardial infarction, in some occasions it cannot provide complete information to sustain the diagnosis. In these situations, the role of modern noninvasive techniques, such as CCTA and CMR, is highly important.…”

Chemokine receptors: Key for molecular imaging of inflammation in atherosclerosis

“…Targets include vascular cell adhesion molecules, metalloproteinases, natriuretic peptide clearance receptors, and, most recently, chemokine receptors. [4][5][6][7][8][9][10][11][12] Some of these targeted radiotracers have been translated for human atherosclerosis imaging. 13,14 Wei and colleagues in their article in this issue of Journal of Nuclear Cardiology have developed a single photon emission computed tomography (SPECT) radiotracer that targets the chemokine receptor CCR5.…”