Advanced Carotid Plaque Imaging

Coronal view of a 50–70% symptomatic stenosis of the internal carotid artery on the left side in a 77-year-old male patient as shown by FDG-PET-CT imaging. No FDG uptake was noted at the level of the asymptomatic stenosis of the internal carotid artery on the contralateral side.

Multispectral near-infrared fluorescence imaging within IVIS Spectrum camera (Caliper Life Sciences, Hopkinton, MA, USA) of a resected left-sided symptomatic >70% carotid stenosis in a 74-year-old woman. Ex vivo plaque in white light (left), near-infrared fluorescence signal before (autofluorescence, middle) and after incubation with MMP-sensitive activatable fluorescent probe (MMPSense, VisEn Medical, Boston, MA, USA; right). After incubation with MMPSense clear hotspots (yellow areas) were identified both at the intraluminal and extraluminal sides, most present in the origin of the internal carotid artery and at the level of the common carotid bulb. (With kind permission of Niels Harlaar and Johannes de Jong, University Medical Center Groningen, Groningen, The Netherlands)

Non-invasive radionuclide imaging of proteolytic (MMP) activity and apoptosis by using ^99mTc-labelled matrix metalloproteinase inhibitor (MPI) and ¹¹¹In-labelled Annexin A5 in atherosclerosis. Micro-SPECT (top), and micro-SPECT-CT fusion images (bottom) of atherosclerotic rabbit on uninterrupted high-cholesterol diet using Tc-MPI (A) and In-AA5 (B). The left sets in A and B display images immediately (0h) after radiotracer administration, which reveal blood pool activity in the aorta (arrows) in front of vertebral column. The right sets in A and B show target localisation 4h after radiotracer administration. The radiotracer uptake in the atherosclerotic lesions of the abdominal aorta is observed (arrows). (With kind permission of A. Petrov, PhD, University of California, Irvine, USA.)