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• W1989469394 abstract "The majority of myocardial infarctions are caused by atherosclerotic plaque rupture. However, identifying lesions at risk of rupture, so-called vulnerable plaques, is challenging. Most are not flow-limiting [1,2] and will therefore not be detected by conventional stress testing or invasive coronary angiography. Other methods are therefore required to improve the prediction of adverse coronary events. The presence of calcium in the coronary arteries is pathognomic of atherosclerosis and can be quantified using computed tomography (CT) and the Agatston score. This provides a surrogate of the coronary atherosclerotic burden and offers powerful cardiovascular risk prediction [3], presumably because with an increasing number of plaques, more are likely to be vulnerable. Vulnerable plaques are known to have certain pathological characteristics, which include inflammation and spotty calcification. Activated macrophages infiltrate the thin fibrous cap, secreting matrix metalloproteinases, which predispose the plaque to rupture [4]. Spotty calcification represents the very earliest stage of the vascular calcific process and is frequently not resolved by CT. Unlike the confluent calcification observed later in the disease process, microcalcif ication increases wall stress, predisposing the plaque to microfractures and rupture [5–7]. We have recently investigated the feasibility of using PET to image these two processes in the coronary arteries [8]. In a cohort of 119 patients, we performed PET/ CT imaging using F-fluorodeoxyglucose (F-FDG) to detect plaque inflammation and F-sodium f luoride (F-NaF) to image calcification. Both tracers are easy to manufacture in modern cyclotrons and are commercially available. F-FDG has become well established as a measure of vascular inflammation [9,10], whereas F-NaF has been used to image new bone formation, primarily cancer metastases, for 50 years. Fluoride ions exchange with hydroxyl ions in exposed hydroxyapatite, a key structural crystal that is deposited in both bone matrix and in the initial stages of vascular calcium formation. Retrospective data derived from the use of F-NaF in cancer imaging have previously suggested that vascular uptake may identify novel or developing regions of arterial calcification [11–13]. In our study results for F-FDG were disappointing, being hampered by myocardial uptake from which it was difficult to isolate activity in the coronary Noninvasive imaging in cardiovascular therapy: the promise of coronary arterial 18F-sodium fluoride uptake as a marker of plaque biology" @default.
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• W1989469394 date "2012-09-01" @default.
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• W1989469394 title "Noninvasive imaging in cardiovascular therapy: the promise of coronary arterial18F-sodium fluoride uptake as a marker of plaque biology" @default.
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• W1989469394 doi "https://doi.org/10.1586/erc.12.104" @default.
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