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Imaging in Cardiovascular Disease
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Standard imaging biomarkers in cancer-FDG-PET/CT
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Up-and-coming imaging biomarkers in cancer
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Utility of atherosclerosis imaging in the evaluation of drug therapies
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Clinical non invasive imaging of plaques
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Why MRI & FDG-PET?
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Moderate Carotid Artery Stenosis: MR Imaging– depicted-Intraplaque Hemorrhage Predicts Risk of Cerebrovascular Ischemic Events in Asymptomatic Men
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Incidence of cerebrovascular events between arteries with (MRIPH Positive) and those without (MRIPH Negative) MR-depicted IPH
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Fe3O4
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Sosnovik D et al. Basic Res Cardiol. 2008 March; 103(2): 122–130
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Risk factors associated with plaque characteristics seen on MRI in various population-based studies
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FDG-PET/CT detection of plaque
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Up-regulation of Glycolysis and Glycolytic Genes With Classic/Innate But Not Alternative Activation
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FDG Uptake By Macrophages
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Measuring atherosclerosis FDG-PET/CT
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First multi-center RCT w statins
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Effect of P38 MAP Kinase Inhibition on Vascular FDG Uptake
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First multi-center multimodal RCT
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Sample MRI Images from a patient at baseline and treated with dalcetrapib 600 mg for 24 Months showing regression in Total Vessel Area (TVA)
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Coronary FDG PET
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Vascular FDG signal identifies future atherothrombotic events
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Imaging intraplaque inflammation in carotid atherosclerosis with 11C-PK11195 PET/CT
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18F-sodium fluoride activity in the aortic valve – active calcification marker?
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1st MR/PET Whole-Body System (Dec 2009):
Integration of low-radiation high-contrast & metabolic information
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• CT limited to photon absorption by tissue or contrast medium
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RECENT MR/PET hardware developments
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Spectral CT with energy-resolving detector
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Multicolor molecular CT imaging
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Multicolor/Spectral CT photon counting imaging
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Cardiovascular nanotechnology: the opportunity
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Osborn EA & Jaffer F JACC Imaging 2012
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HDL: a contrast/drug delivery platform
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Nanoparticle – Drug Delivery
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High Risk Patients: New Treatment Paradigm
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Nanoparticle (NP)-glucocorticoids (1 injection) with imaging used to evaluate efficacy - FDG-PET/CT
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1st in man trial with glucocorticoids liposomes for atherosclerosis treatment@AMC, Netherlands
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Statins have high liver uptake and low bioavailability to atherosclerotic macrophages
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Statin loaded rHDL nanoparticles ([S]-rHDL) target atherosclerotic macrophages
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Summary
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