Modern imaging techniques of vulnerable atherosclerotic plaque on coronary arteries

Abstract

The availability of powerful imaging techniques has the potential to improve our understanding of the biology of the vulnerable plaque in atherosclerosis. Vascular remodelling manifests as either expansive or restrictive, and changes in the vessel wall composition (hypertrophy or hypotrophy) are common to all vascular pathologies. Enzymes involved in dissolving the extracellular matrix and proliferating cells comprising the neointima can be targeted for imaging. Inflammation is an important component of atherosclerosis. A positron-labelled probe, 18F-FDG, is widely available for tumour imaging and shows a promise as a marker of inflammatory activity of atherosclerotic plaque and plaque burden. Single photon-labelled probe that binds the LOX-1 LDL receptor on macrophages for oxidized LDL shows a promise as an agent for imaging inflammation in atherosclerosis. Radiolabelled MPIs that target both inflammation and remodelling show a promise in preclinical experiments. Nanoparticles with paramagnetic properties have been designed to target angiogenesis, which is an important process in advanced atherosclerotic plaque leading to intraplaque hemorrhage and instability. Ironbased particles, USPIOs, are taken up by macrophages in atheroma, and USPIO-MRI has the potential to become an approach to image inflamed and active atherosclerotic plaques. Despite the current technological limits, we believe that these imaging methods of atherosclerotic plaques are very promising approaches for being tested in clinical studies.