18F-Fluoride as a marker of unstable atheroma – A Perspective


The techniques currently available to detect myocardial and cerebral ischemia identify patients with advanced atherosclerosis. Localization and characterization of atheroma prior to a clinical event would allow a therapeutic intervention before any loss of function due to ischemia or infarction. To achieve a high level of specificity, the imaging technique should highlight lesions with a potential to cause a clinical event.

Several radiopharmaceuticals have been described to identify inflamed, thin-cap atheroma. Of these, ionic 18F- as fluoride ion, may be the most useful. Preliminary studies suggest that 18F- does not usually localize in areas of dense vascular calcification, but does localize in areas of microcalcification. Although the local pathophysiology required for fluoride localization is not fully understood, it appears that localization occurs in regions of severe inflammation. The lack of significant uptake in normal myocardium or normal brain, suggest that low levels of fluoride uptake should provide a sufficient signal to detect small lesions. Although more work is needed to develop standard methods of quantitation and image mapping, 18F-PET-CT imaging may be useful to identify vulnerable atheroma.

Key words: 18F; atheroma; PET-CT; vulnerable plaque; microcalcification.

Citation: Strauss HW, Mariani G, Volterrani D. 18F-Fluoride as a marker of unstable atheroma – A Perspective. Journal of Diagnostic Imaging in Therapy. 2014; 1(1): 129-136.  

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DOI: http://dx.doi.org/10.17229/jdit.2014-1118-009

Copyright: © 2014 Strauss HW, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are cited.  

Received: 06 November 2014 | Revised: 14 November 2014 | Accepted: 17 November 2014

Published Online 18 November 2014 http://www.openmedscience.com

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