Journal of Nuclear Cardiology

, Volume 26, Issue 1, pp 141–153 | Cite as

Imaging the event-prone coronary artery plaque

  • Andreas A. Giannopoulos
  • Dominik C. Benz
  • Christoph Gräni
  • Ronny R. BuechelEmail author
Review Article


Acute coronary events, the dreaded manifestation of coronary atherosclerosis, remain one of the main contributors to mortality and disability in the developed world. The majority of those events are associated with atherosclerotic plaques-related thrombus formation following an acute disruption, that being rupture or erosion, of an event-prone lesion. These historically termed vulnerable plaques have been the target of numerous benchtop and clinical research endeavors, yet to date without solid results that would allow for early identification and potential treatment. Technological leaps in cardiovascular imaging have provided novel insights into the formation and role of the event-prone plaques. From intracoronary optical coherence tomography that has enhanced our understanding of the pathophysiological mechanisms of plaque disruption, over coronary computed tomography angiography that enables non-invasive serial plaque imaging, and positron emission tomography poised to be rapidly implemented into clinical practice to the budding field of plaque imaging with cardiac magnetic resonance, we summarize the invasive and non-invasive imaging modalities currently available in our armamentarium. Finally, the current status and potential future imaging directions are critically appraised.


Coronary artery disease acute coronary syndromes computed tomography (CT) PET/CT imaging vulnerable atherosclerotic plaque 



Thin cap fibroatheroma


Optical coherence tomography


Endothelial shear stress


Intravascular ultrasound


Near-infrared spectroscopy


Coronary computed tomography angiography


Acute coronary syndrome


Positron emission tomography


Cardiac magnetic resonance


Coronary artery disease



The authors do not have any personal conflicts of interest to declare. However, the University Hospital Zurich holds a research agreement with GE Healthcare.

Supplementary material

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Supplementary material 1 (PPTX 1124 kb)


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Copyright information

© American Society of Nuclear Cardiology 2017

Authors and Affiliations

  • Andreas A. Giannopoulos
    • 1
  • Dominik C. Benz
    • 1
  • Christoph Gräni
    • 1
  • Ronny R. Buechel
    • 1
    Email author
  1. 1.Department of Nuclear Medicine, Cardiac ImagingUniversity Hospital ZurichZurichSwitzerland

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