Non-invasive imaging of atherosclerosis regression with magnetic resonance to guide drug development

Abstract

Slowing of progression and inducing the regression of atherosclerosis with medical therapy have been shown to be associated with an extensive reduction in risk of cardiovascular events. This proof of concept was obtained with invasive angiographic studies but these are, for obvious reasons, impractical for sequential investigations. Non-invasive imaging has henceforth replaced the more cumbersome invasive studies and has proven extremely valuable in numerous occasions. Because of excellent reproducibility and no radiation exposure, magnetic resonance imaging (MRI) has become the non-invasive method of choice to assess the efficacy of anti-atherosclerotic drugs. The high accuracy of this technology is particularly helpful in rare diseases where the small number of affected patients makes the conduct of outcome-trials in large cohorts impractical. With MRI it is possible to assess the extent, as well as the composition, of atherosclerotic plaques and this further enhances the utility of this technology.

The future of imaging in cardiovascular disease intervention trials: 2017 and beyond

“…13 High spatial-resolution imaging of the carotid vessels is readily feasible, with accurate, reproducible measurements of carotid plaque thickness, volume and area derived from black-blood imaging sequences.…”

Improved Detection of Molecular Markers of Atherosclerotic Plaques Using Sub-Millimeter PET Imaging

“…The joint ESC Guidelines suggested that early diagnosis of high-risk patients could be equally effective as preventing new cases, leading to potential cost-savings, and consequently encouraged research regarding risk assessment by non-or minimally invasive imaging techniques [3]. Techniques such as multi-detector CT [4,5], intravascular ultrasound [6,7], MRI [8,9], or Optical Coherence Tomography [10] are extensively being investigated for the assessment of morphological or structural characteristics of atherosclerotic lesions. Among the molecular imaging modalities, which can reveal specific biological aspects of atherosclerotic plaques, positron emission tomography/computed tomography (PET/CT) is one of the preferred techniques in clinic [11].…”

VHPKQHR peptide modified magnetic mesoporous nanoparticles for MRI detection of atherosclerosis lesions

“…Thus, timely and precise diagnosis and effective treatment are essential to delay the progression of the disease and to improve the survival rate. In comparison with other diagnostic methods, such as computed tomography (CT), ultrasonic imaging, and positron emission computed tomography (PET), magnetic resonance imaging (MRI) is widely used in clinical for its advantages of no invasion, no radiation and high soft tissue contrast in imaging [4,5]. Although the contrast agents such as iron and gadolinium agent increase the imaging effectiveness [6], MRI is still difficult to distinguish between small abnormal and normal tissues.…”