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European Heart Journal Advance Access originally published online on October 15, 2009
European Heart Journal 2009 30(21):2566-2574; doi:10.1093/eurheartj/ehp419
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org
The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that the original authorship is properly and fully attributed; the Journal, Learned Society and Oxford University Press are attributed as the original place of publication with correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org.

Imaging of the unstable plaque: how far have we got?

Christian M. Matter1,2,*, Matthias Stuber3,4 and Matthias Nahrendorf5

1 Cardiovascular Research, Institute of Physiology, Zurich Center for Integrative Human Physiology, University of Zurich, Zurich 8057, Switzerland
2 Cardiology, Cardiovascular Center, University Hospital Rämistrasse 100, 8091 Zürich, Switzerland
3 Division of Magnetic Resonance Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
4 Department of Radiology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne 1011, Switzerland
5 Center for Systems Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA

Received 30 June 2009; revised 31 August 2009; accepted 17 September 2009 * Corresponding author. Tel: +41 44 635 6467, Fax: +41 44 635 6827, Email: cmatter{at}physiol.uzh.ch

Rupture of unstable plaques may lead to myocardial infarction or stroke and is the leading cause of morbidity and mortality in western countries. Thus, there is a clear need for identifying these vulnerable plaques before the rupture occurs. Atherosclerotic plaques are a challenging imaging target as they are small and move rapidly, especially in the coronary tree. Many of the currently available imaging tools for clinical use still provide minimal information about the biological characteristics of plaques, because they are limited with respect to spatial and temporal resolution. Moreover, many of these imaging tools are invasive. The new generation of imaging modalities such as magnetic resonance imaging, nuclear imaging such as positron emission tomography and single photon emission computed tomography, computed tomography, fluorescence imaging, intravascular ultrasound, and optical coherence tomography offer opportunities to overcome some of these limitations. This review discusses the potential of these techniques for imaging the unstable plaque.

Key Words: Atherosclerosis • Molecular imaging • Vulnerable plaque


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