Vulnerable plaque imaging comes a step closer

We published a paper in the Lancet last week.

It is the result of a scientific collaboration between Edinburgh and Cambridge Universities. Funding was provided by the British Heart Foundation and the Chief Scientist's Office in Scotland.

The project concerns using PET imaging with NaF to detect atherosclerotic plaques that are in a state of vulnerability to rupture.

Firstly, NaF successfully identified most of the plaques that had caused recent MI because they were brighter after PET imaging than bystander lesions.

We then used IVUS to clarify, in a stable angina cohort, the phenotype of NaF-avid plaques. We also confirmed using immunohistochemistry that NaF binding occurred in areas of both high calcium turnover and inflammation.

The reason that the study is exciting is that it sets the scene for this imaging to be used prospectively, perhaps in high-risk individuals with lesions in several arteries, where it might direct therapy to the most "at-risk" plaques. This might be intensive statin therapy, or even a direct plaque intervention of some type.

We still don't know whether high-risk plaque detection and treatment will alter the natural history of the disease or how cost effective such an approach might be. But it has a major advantage of being non-invasive and relatively low in radiation - about half the dose of a nuclear perfusion scan. There is also no fasting needed before scanning, and NaF is widely available.

The publication received a great deal of media coverage:

  1. The Daily Mail
  2. The Scottish Herald
  3. The Guardian
  4. BBC
  5. More BBC
  6. Even more BBC
  7. Daily Record
  8. The Express
  9. The Huffington Post
  10. The Independent
  11. More Independent
  12. Medical News Today
  13. Medscape
  14. The NHS website
  15. Pulse Today
  16. The Scotsman
  17. Scottish TV
  18. The Information Daily
  19. The Times
  20. WebMD