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Advances in detection and characterization of atherosclerosis using contrast agents targeting the macrophage

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Journal of Nuclear Cardiology Aims and scope

Abstract

With advances in imaging technology and our understanding of the role of inflammation in atherosclerosis, the macrophage appears to be an excellent target for imaging the progression of disease. In addition to imaging the macrophage with only 1 modality, contrast agents can be created that can be imaged with multiple modalities. This seems extremely attractive, as lesion morphology and characteristics can be determined with modalities that provide high picture resolution, such as CT or MRI, whereas macrophage quantity can be accurately determined through the creation of a radiolabeled contrast agent such as FDG via PET. Although this combination of imaging technologies may yield clinically useful data, the associated cost would likely be quite high, and further studies are necessary to validate this approach before it achieves widespread use. The area in which macrophage detection may reach wide clinical utility first is likely the detection of high-risk carotid atherosclerotic plaque. If limitations in coronary image resolution are overcome in the setting of MRI and other imaging technologies, the ability to detect high-risk lesions in the coronary tree through molecular imaging may greatly change how we determine which lesions require therapy and how patients are managed. Therefore we believe that contrast agents that specifically target the macrophage may aid in the detection and risk stratification of atherosclerotic plaque and aid in determining which therapy will best reduce patient morbidity and mortality rates.

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Authors and Affiliations

  1. Department of Internal Medicine, University of Virginia Health System, Charlottesville, Va

    Michael J. Lipinski

  2. Institute of Molecular Science, University of Valencia, Valencia, Spain

    Juan Carlos Frias

  3. The Zena and Michael A. Wiener Cardiovascular Institute and The Marie-Josée and Henry R. Kravis Cardiovascular Health Center, Mount Sinai School of Medicine, New York, NY

    Zahi A. Fayad

  4. Imaging Science Laboratories, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1234, 10029, New York, NY

    Zahi A. Fayad

  5. Departments of Radiologye, Mount Sinai School of Medicine, New York, NY

    Zahi A. Fayad

  6. Medicine, Mount Sinai School of Medicine, New York, NY

    Zahi A. Fayad

Authors
  1. Michael J. Lipinski
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  2. Juan Carlos Frias
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  3. Zahi A. Fayad
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Correspondence to Zahi A. Fayad.

Additional information

Partial support was provided by National Institutes of Health/National Heart, Lung, and Blood Institute grants R01 HL71021 and R01 HL78667 (Z.A.F.), as well as The Zena and Michael A. Wiener Cardiovascular Institute and The Marie-Josée and Henry R. Kravis Cardiovascular Health Center and Department of Radiology, Mount Sinai School of Medicine, and the Stanley J. Sarnoff Endowment for Cardiovascular Science (M.J.L.).

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Lipinski, M.J., Frias, J.C. & Fayad, Z.A. Advances in detection and characterization of atherosclerosis using contrast agents targeting the macrophage. J Nucl Cardiol 13, 699–709 (2006). https://doi.org/10.1016/j.nuclcard.2006.07.004

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