Computed Tomographic Coronary Angiography Identification of Plaque Inflammation: An Imaging Target Within Reach?

The role of inflammation in the development and progression of coronary atherosclerosis has long been postulated. The inflammatory response to vascular injury initiates and propagates the development of atherosclerotic plaques; this same process plays a key role in plaque destabilization and the progression to adverse events.¹ Indeed, recent randomized clinical trials now support a role for pharmacotherapy that targets inflammation as providing clinical benefit in patients with coronary artery disease (CAD) despite a lack of reduction in lipid levels.¹ Numerous attempts to image plaque inflammations have been made with limited success to date. The ability to image plaque inflammations may provide multiple benefits, including insights into pathophysiology, potential patient risk stratification, and a possible optimization of patient care. Hence, identifying plaque inflammation is an imaging target of significant interest and importance, particularly if the information can be easily collected as a part of ongoing routine care.