Non-invasive detection of vulnerable coronary plaque

Table 1 Characteristics of the “ideal” non-invasive imaging modality

Patient-related factors	Technical factors
Absence of ionizing radiation	Rapid image acquisition
Spacious (minimize claustrophobia)	High spatial resolution
Suitable for all (not precluded by aneurysm clips/pacemaker leads)	High contrast resolution
Absence of breath-holding	High temporal resolution
Administration of extrinsic contrast agents unnecessary	Electrocardiogram and respiratory gating
Wide range of clinical indications	Not limited by cardiac arrhythmia
	Provides both anatomic and metabolic information
	Reproducible
	Accurate

Table 2 Selected molecular imaging agents in cardiovascular disease

Biological process	Agent	Target	Imaging platform
Plaque rupture/thrombosis	Gadolinium carrying perfluorocarbon and peptides (EP-2104R)	Fibrin	MRI
	Phage display nanoparticles generated by CEST 99mTc-apcitide	Glycoprotein IIb/IIIa receptor	SPECT
Inflammation/apoptosis	MNP + specific antibodies	E-selectin	MRI
	Monocrystalline iron oxide	ICAM/VCAM	PET
	Cross-linked iron oxide 18FDG	Macrophages glucose transporter-1, hexokinase	SPECT
	99mTc-annexin	Phosphatidylserine/caspases	SPECT
	99mTc-interleukin-2	Lymphocytes
Angiogenesis	MNP + specific antibody 99mNC100692	VCAM-1/integrin αvβ3	MRI
Myocardial infarction	MNP 111Indium oxide	Stem cell labeling	MRI/SPECT

MNP: Paramagnetic nanoparticle; CEST: Chemical exchange saturation transfer; MRI: Magnetic resonance imaging; SPECT: Single photon emission computed tomography; PET: Positron emission tomography; ICAM: Intercellular adhesion molecule; VCAM: Vascular cell adhesion molecule;

¹⁸FDG: Fluorine-18 fluorodeoxyglucose.