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Cardiovascular medicine is another area in which imaging has become a routine part of medical practice. The chronic and progressive nature of atherosclerosis requires the registration of new therapies for this condition to be based on long-term clinical outcome trials. As with any disease-modifying therapy, there is a critical need to select and prioritize drug targets and to personalize therapy by identifying plaque subtypes (e.g., high-risk vulnerable plaques) that can be linked to the most appropriate therapeutic interventions (www.hrpinitiative.com/hrpinit).
Molecular imaging agents directed against plaque-specific targets could be used to highlight patients for clinical trials in drug development and in the future could form the basis of diagnostic molecular imaging alongside conventional CT- and MRI-based structural and intravascular imaging approaches.
However, despite considerable efforts using genetic and proteomic analysis of atherosclerotic plaque to identify targets, no molecular imaging agents have yet progressed into routine experimental use or been incorporated into clinical trials.
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