Advances in molecular imaging of atherosclerotic vascular disease

Purpose of review Molecular imaging aims to illuminate vital molecular and cellular aspects of disease in vivo, and is rapidly translating into the clinical arena. Advantages of this field include enabling serial biological studies in living subjects, assessment of pharmaceutical efficacy, and in-vivo characterization of clinical diseases. Here we present recent exciting advances in molecular imaging of atherosclerotic vascular disease. Recent findings Atherosclerosis molecular imaging approaches are now available for magnetic resonance, nuclear, computed tomography, ultrasound, and near-infrared fluorescence imaging. Advances in agent synthesis and detection technology are now enabling in-vivo imaging of endothelial cell activation, macrophages, cellular metabolism, protease activity, apoptosis, and osteogenic activity. Several agents show clinical utility for the detection of high-risk plaques. Summary Molecular imaging is actively unraveling the biological basis of atherosclerosis in living subjects. In the near-term, molecular imaging will play an important role in assessing novel atherosclerosis pharmacotherapies in clinical trials. Longer term, molecular imaging should enable accurate identification of high-risk plaques responsible for myocardial infarction, stroke, and ischemic limbs.