Gamma imaging of atherosclerotic plaques

Noninvasive gamma imaging of atherosclerotic plaques targets various metabolic aspects of atherogenesis. Vascular endothelial dysfunction or denudation resulting in the expression of adhesion molecules that attract inflammatory cells and increased vascular permeability has also been targeted. Enzymes and molecules associated with apoptosis of these inflammatory cells have provided additional targets, such as oxidized low-density lipoprotein, matrix metalloproteinases, and phosphatidylserine. In late atherosclerotic lesions, the lipid core as well as proliferating smooth muscle cells have been imaged successfully. Platelets and fibrin deposition may also be targeted to demonstrate thrombosis in plaque rupture or erosion. However, no unimodal approach can diagnose plaque vulnerability. It will require multi-modal, multitasking approaches for molecular diagnostic prediction of plaque vulnerability and impending rupture. Existing experimental and clinical gamma imaging applications in atherosclerotic lesion imaging are reviewed. Improvement by signal amplification to image small lesion and the concept of multimodal applications are introduced.