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PET Imaging of Atherosclerotic Disease: Advancing Plaque Assessment from Anatomy to Pathophysiology.

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Evans, Nicholas R 
Tarkin, Jason M 
Chowdhury, Mohammed M 
Warburton, Elizabeth A 
Rudd, James HF 


Atherosclerosis is a leading cause of morbidity and mortality. It is now widely recognized that the disease is more than simply a flow-limiting process and that the atheromatous plaque represents a nidus for inflammation with a consequent risk of plaque rupture and atherothrombosis, leading to myocardial infarction or stroke. However, widely used conventional clinical imaging techniques remain anatomically focused, assessing only the degree of arterial stenosis caused by plaques. Positron emission tomography (PET) has allowed the metabolic processes within the plaque to be detected and quantified directly. The increasing armory of radiotracers has facilitated the imaging of distinct metabolic aspects of atherogenesis and plaque destabilization, including macrophage-mediated inflammatory change, hypoxia, and microcalcification. This imaging modality has not only furthered our understanding of the disease process in vivo with new insights into mechanisms but has also been utilized as a non-invasive endpoint measure in the development of novel treatments for atherosclerotic disease. This review provides grounding in the principles of PET imaging of atherosclerosis, the radioligands in use and in development, its research and clinical applications, and future developments for the field.



Atherosclerosis, Carotid stenosis, Coronary artery disease, Positron emission tomography, Atherosclerosis, Humans, Plaque, Atherosclerotic, Positron-Emission Tomography

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Current Atherosclerosis Reports

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Springer Nature
Wellcome Trust (104492/Z/14/Z)
British Heart Foundation (None)
British Heart Foundation (None)
The Dunhill Medical Trust (None)
NRE is supported by a research training fellowship from The Dunhill Medical Trust [grant number RTF44/0114]. JMT is supported by a Wellcome Trust research training fellowship (104492/Z/ 14/Z). MMC is part-supported by the Royal College of Surgeons of England Fellowship Program. JHFR is part-supported by the HEFCE, the NIHR Cambridge Biomedical Research Centre, the British Heart Foundation, and the Wellcome Trust