Novel Positron Emission Tomography Tracers for Imaging Vascular Inflammation
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NUCLEAR CARDIOLOGY (V DILSIZIAN, SECTION EDITOR)
Novel Positron Emission Tomography Tracers for Imaging Vascular Inflammation Andrej Ćorović 1 & Christopher Wall 1 & Justin C. Mason 2 & James H. F. Rudd 1 & Jason M. Tarkin 1,2
# The Author(s) 2020
Abstract Purpose of Review To provide a focused update on recent advances in positron emission tomography (PET) imaging in vascular inflammatory diseases and consider future directions in the field. Recent Findings While PET imaging with 18F-fluorodeoxyglucose (FDG) can provide a useful marker of disease activity in several vascular inflammatory diseases, including atherosclerosis and large-vessel vasculitis, this tracer lacks inflammatory cell specificity and is not a practical solution for imaging the coronary vasculature because of avid background myocardial signal. To overcome these limitations, research is ongoing to identify novel PET tracers that can more accurately track individual components of vascular immune responses. Use of these novel PET tracers could lead to a better understanding of underlying disease mechanisms and help inform the identification and stratification of patients for newly emerging immune-modulatory therapies. Summary Future research is needed to realise the true clinical translational value of PET imaging in vascular inflammatory diseases. Keywords PET . Inflammation . Atherosclerosis . Large-vessel vasculitis . Molecular imaging . Non-invasive imaging
Introduction
This article is part of the Topical Collection on Nuclear Cardiology * Jason M. Tarkin [email protected] Andrej Ćorović [email protected] Christopher Wall [email protected] Justin C. Mason [email protected] James H. F. Rudd [email protected] 1
Division of Cardiovascular Medicine, University of Cambridge, Cambridge, UK
2
Cardiovascular Division, National Heart & Lung Institute, Imperial College London, London, UK
Inflammation is the cause or consequence of many cardiovascular diseases. In particular, inflammation is central to the pathogenesis of atherosclerosis [1], the most common cause of myocardial infarction and ischaemic stroke. Large-vessel vasculitis (LVV) is another important vascular inflammatory disease, which is associated with progressive arterial injury and accelerated coronary atherosclerosis. Non-invasive imaging is a key component of the diagnostic and disease-monitoring pathways for these cardiovascular inflammatory diseases. While echocardiography, CT, MRI, and nuclear perfusion imaging are first-line non-invasive cardiac investigations, positron emission tomography (PET) imaging of inflammation can also play an important clinical role. Moreover, advances in cardiovascular PET imaging research and technology, including hybrid PET/MRI and total body PET, may open new clinical translational avenues in the near future. In atherosclerosis, vascular inflammation detected by PET may serve as a marker of high-risk plaques or overall heightened disease activity. This approach could be particularly important in the post CANTOS (Canakinumab Antiinflammatory Thr
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