Role of 18F-sodium fluoride positron emission tomography in imaging atherosclerosis

Atherosclerosis involving vascular beds across the human body remains the leading cause of death worldwide. Coronary and peripheral artery disease which are almost universally a result of atherosclerotic plaque can manifest clinically as myocardial infarctions, ischemic stroke or acute lower limb ischemia. Beyond imaging myocardial perfusion and blood flow nuclear imaging has the potential to depict the activity of the processes which are directly implicated in the atherosclerotic plaque progression and rupture. Out of several tested tracers to date the literature is most advanced for 18F-sodium fluoride positron emission tomography. In this review we present the latest data in the field of atherosclerotic 18F-sodium fluoride positron emission tomography imaging, discuss the advantages and limitation of the techniques, and highlight the aspects which require further research in the future.