Molecular imaging of the atherosclerotic plaque using positron emission tomography

Accurately assessing an individual's risk of myocardial infarction or stroke using currently available risk stratification tools remains a challenge, even in patients with symptomatic disease. Inflammation, micro-calcification and intra-plaque angiogenesis occur during the development and ultimate rupture of vulnerable plaques. Molecular imaging techniques such as combined positron emission tomography and computed tomography (PET/CT) offer the opportunity to target these key cellular processes within atheroma and identify high-risk lesions. In this review we will set out the studies that have demonstrated the feasibility of PET/CT imaging in assessing atherosclerotic plaque inflammation, micro-calcification and angiogenesis. We will also discuss the potential of PET/CT molecular imaging as both a screening tool for novel therapeutic interventions and as a means of improving cardiovascular risk stratification.