Imaging High-Risk Atherosclerotic Plaques with PET

Atherosclerotic disease, a primary cause of stroke and myocardial infarction, is the most common underlying cause of death worldwide. While atherosclerosis was formerly considered to be a relatively inert structural abnormality, decades of research have since shown that it is a biologically active process, driven by active inflammation. In concert with this conceptual shift, newer strategies to image vascular lesions have evolved. 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging has been validated as a non-invasive tool to characterize atherosclerotic inflammation. It is hypothesized that a combination of structural and biological (e.g., inflammatory) imaging may provide better means to assess clinical risk, to assess efficacy of therapy, and to identify new, effective treatments. Limitations remain, however, and further advances in technology and tracer development are required before FDG PET imaging will contribute a significant clinical impact at the level of the individual patient.