Day 3 ESC

A very well attended session at the ESC today concerned novel approaches to imaging the vulnerable plaque.

We heard from Zahi Fayad (New York), Jagat Narula (Orange, Ca) and Beat Kaufmann from Basel in Switzerland. I gave an over-view of vascular PET imaging, both with FDG and novel targeted ligands against plaque macrophages.

The session tried to communicate not only the state of play in 2010, but also to predict what may be around the corner for imaging. There seems to be a move towards more platform integration, with the appearance of combined PET/MR hardware. This will allow high sensitivity/high resolution imaging of the artery wall. I guess this will have large impact in brain imaging and likely also in cardiology for myocardial imaging.

For CT, as well as a move to lower radiation dose, Zahi Fayad talked about multi-color CT, something that holds great promise in separating out the various plaque elements, to a much greater extent than currently feasible with single energy imaging with iodine contrast agents. This work was recently published in Radiology (Cormode D et al - see image below).

We also heard a great review of ultrasound imaging of vulnerable plaque, using targeted microbubbles against selectins and adhesion molecules. Whilst very exciting, the field is confined right now to small animal models of disease, and to epitopes expressed on endothelial cells. But there is promise of eventual human translation.

What caught your eye in Stockholm today?