Imaging inflammation in atherosclerosis: Exploring all avenues

Abstract

Despite remarkable advances in preventive and therapeutic strategies, cardiovascular disease (CVD) remains the primary source of death and disability worldwide. 1 Further, the demographic shift towards an older population will result in increasing numbers of patients, among whom heart disease is the leading cause of death. In view of this global burden, personalized risk-stratification tools and a cost-effective management of CVD are urgently needed. Although rapid innovations in atherosclerosis imaging have widened its applications from anatomical plaque detection to physiological assessment and complex evaluation of vascular biology, non-invasive imaging tools that flag the 'vulnerable' patient are still lacking. Indeed, although the presence of coronary artery stenosis is associated with subsequent events, most myocardial infarctions occur in segments with non-obstructive rather than obstructive disease. 2 As recent landmark trials have further highlighted the fundamental role of inflammation during all stages of See related article, https://doi.

Radiochemistry for positron emission tomography

“…In addition, [ 13 N]NH 3 serves as a building block for further 13 N-transformations, such as efficient enzymatic preparations of 13 N-labeled amino acids from [ 13 N]NH 3 . [ 15 O]H 2 O is produced via the 14 N(d,n) 15 O nuclear reaction 61 , and [ 15 O]H 2 O is the most widely used 15 O-labeled PET tracer and constitutes the current gold standard for cerebral blood flow measurements.…”

“…As such, PET is ideally suited for visualizing molecular and cellular events that occur early in the course of a disease or following therapeutic intervention 9 . Further, depending on the applied tracer, PET can be used to gain prognostic information, offering a valuable risk-stratification tool in clinical practice, as it is currently performed with various probes in atherosclerotic inflammation imaging 2 , 15 .…”