Targeted Molecular Imaging to Detect Vascular Disease
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Targeted Molecular Imaging to Detect Vascular Disease Wouter Driessen & Patrick H. Kee
Published online: 3 July 2010 # Springer Science+Business Media, LLC 2010
Abstract Major challenges with vascular imaging are related to the deep-seated nature of blood vessels, small dimensions of the lumen, and poor access into the arterial wall. Current imaging techniques are limited to detecting structural abnormalities. To detect minute abnormalities in the vascular lumen or arterial wall, imaging techniques need to be modified to improve their spatial resolution and sensitivity as well as to develop unique homing mechanisms to target biomarkers expressed in the lumen or the wall of the blood vessels. Molecular imaging has the potential to detect pathologic biomarkers that would otherwise be difficult to be detected by current imaging techniques. This review provides an overview of the uses of molecular imaging to detect two major vascular conditions, thrombosis and atherosclerosis. Molecular imaging has the potential to screen for early stages of disease, follow the course of the disease, and detect the presence of vulnerable plaque or occult thromboses that require aggressive intervention. Keywords Atherosclerosis . Molecular imaging . Thrombosis
W. Driessen David H. Koch Center, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA e-mail: [email protected] P. H. Kee (*) Division of Cardiology, Department of Internal Medicine, The University of Texas Health Science Center at Houston, 6431 Fannin, MSB 1.247, Houston, TX 77030, USA e-mail: [email protected]
Introduction Molecular imaging is based on the principle that molecular changes at a cellular level precede gross anatomic changes in the affected organ. This imaging technique is particularly useful in two disease states: 1) early disease conditions expressing biomarkers that cannot be detected by anatomybased or functional-based imaging, and 2) advanced disease conditions with dimensions that are too small for detection. Thus, molecular imaging aims to target specific biomarkers expressed in these pathologic structures and amplify the signal of such interaction so that detection can occur. Atherosclerosis is clearly a vascular condition that can benefit from both early detection and definitive diagnosis. Although considered the first choice in the diagnosis of obstructive vascular disease, detection of luminal narrowing by contrast angiography is an incomplete representation of the disease process in the arterial wall during the development of atherosclerosis. Glagov et al. [1] have demonstrated the ability of the artery to accommodate atheroma in the wall by outward expansion (positive remodeling) for prolonged duration prior to the encroachment of lumen (negative remodeling) in advanced disease. Molecular pathways responsible for the development of various stages of atherosclerosis are currently under study, and the research focuses on inflammatory pathways that play an important role in the recruitment of inflammatory cells, lipid depo
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