Na-fluoride PET for identification of high-risk coronary atherosclerotic plaques-Lancet Reports

Nikhil Joshi et al in The Lancet, Early Online Publication, 11 November 2013 doi:10.1016/S0140-6736(13)61754-7  discuss the use of non-invasive imaging to identify ruptured or high-risk coronary atherosclerotic plaques which would represent a major clinical advance for prevention and treatment of coronary artery disease. 

Brief:

"In this prospective clinical trial, patients with myocardial infarction and stable angina  underwent 18F-NaF and 18F-FDG PET-CT, and invasive coronary angiography. 18F-NaF uptake was compared with histology in carotid endarterectomy specimens from patients with symptomatic carotid disease, and with intravascular ultrasound in patients with stable angina.  In 37 patients with myocardial infarction, the highest coronary 18F-NaF uptake was seen in the culprit plaque. By contrast, coronary 18F-FDG uptake was commonly obscured by myocardial uptake and where discernible, there were no differences between culprit and non-culprit plaques  18F-NaF PET-CT is the first non-invasive imaging method to identify and localise ruptured and high-risk coronary plaque. "

This possibly is path breaking in CAD imaging and further studies are needed to establish whether this method can improve the management and treatment of patients with coronary artery disease.