Dr. Paolo Camici,
The aim of the session was to provide an update on non invasive imaging of vascular inflammation and atherosclerosis with particular emphasis on the applications for imaging vulnerable atherosclerotic plaques.
Prof Virmani highlighted the importance of changes in shear stress for the formation of the initial lesions that promote the growth of atherosclerotic plaques. She then discussed the features of “non-progressive” and “progressive” coronary plaques highlighting the morphologic characteristics of each lesion. Among the different aspects of this phenomenon she insisted on the role of monocyte/macrophage in progression of the plaque and formation of the thin cap. These cells through a series of mechanisms, play a pivotal role in the events that lead to the progression and rupture of the thin cap with formation of thrombi.
Dr Gaemperli discussed the applications of CT to plaque imaging that he divided into two groups:
Dr Rudd discussed the application of PET to imaging of the plaque. He summarised the numerous studies conducted with the glucose analogue FDG which have provided important information on the process of plaque inflammation although he also highlighted he limitations of this tracer mainly due to its low specificity. He then discussed two new tracers (PK11195 and NaF) which possess interesting features for imaging macrophages and calcium metabolism respectively. Dr Yilmaz discussed the applications of MRI for the assessment of plaque morphology/remodelling and composition. This technique has unique features that could contribute to plaque characterization; it has high spatial resolution and allows evaluation of plaque composition. One major drawback is long acquisition time. Dr Van Der Steen concluded the session summarising the well known applications of IVUS and OCT for invasive plaque imaging. An in depth review on the subject has been recently published by Camici et al. (European Heart Journal 2012; 33: 1309 - 1317)
Early atherosclerosis imaging: role of different non-invasive modalities
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