Department of Nuclear Medicine, Centre Hospitalier Universitaire Bichat, Assistance Publique - Hôpitaux de Paris, Département Hospitalo-Universitaire FIRE, Inserm 1148, Université Paris Diderot, 46 rue Henri Huchard, 75018, Paris, France.
J Nucl Cardiol. 2019 Oct;26(5):1705-1708. doi: 10.1007/s12350-018-1289-5. Epub 2018 Apr 26.
The presence of inflammatory cells is a hallmark of unstable atherosclerotic plaques. Several imaging approaches have been developed for the noninvasive detection of inflammatory activities in atherosclerotic plaques. Positron emission tomography (PET) imaging with the injection of 18F-fluorodeoxyglucose (FDG) is currently the most widely used imaging technique to evaluate the density of activated macrophages in atherosclerotic plaques. Nevertheless, FDG-PET imaging has logistical and technical constraints that represent an important obstacle to the wider use of this approach for the evaluation of patients with atherosclerosis. In a similar way as in the oncological field, the balance between the benefits and costs of new drugs need to be improved in patients with cardiovascular diseases. PET imaging of plaque inflammation might represent a very useful tool to identify patients who could benefit the most from anti-inflammatory treatments and to exclude patients with other causes of inflammation who are the most likely to develop severe side effects under these drugs. The availability of radiotracers targeting more specifically inflammation in atherosclerotic plaques would greatly facilitate the logistic organization of this imaging and help to expand the use of PET for the evaluation of atherosclerotic patients.
炎症细胞的存在是动脉粥样硬化斑块不稳定的一个标志。已经开发出几种非侵入性检测动脉粥样硬化斑块炎症活性的成像方法。正电子发射断层扫描（PET）成像通过注射 18F-氟脱氧葡萄糖（FDG），目前是评估动脉粥样硬化斑块中活化巨噬细胞密度的最广泛使用的成像技术。然而，FDG-PET 成像存在后勤和技术限制，这是该方法在评估动脉粥样硬化患者中广泛应用的一个重要障碍。与肿瘤学领域类似，心血管疾病患者中新药物的获益与成本之间的平衡需要得到改善。动脉粥样硬化斑块炎症的 PET 成像可能是一种非常有用的工具，可以识别最有可能从抗炎治疗中获益的患者，并排除其他炎症原因的患者，因为这些患者最有可能在这些药物下出现严重的副作用。针对动脉粥样硬化斑块炎症更具特异性的示踪剂的可用性将极大地促进这种成像的后勤组织，并有助于扩大 PET 在评估动脉粥样硬化患者中的应用。
