A new medical-imaging technique will allow cardiologists to visualise plaque build-up in patients’ arteries in three dimensions, highlighting potential problems before symptoms develop.
Crucially, it should allow clinicians to make more accurate decisions about how best to treat their patients, for example, by suggesting lifestyle changes or adapting their medical treatment.
‘I imagine we could come up with an index for plaque burden that would hopefully have a high prognostic value. This could be added to the Framingham risk factor [the current gold-standard model for heart disease], where you have smoking, hypertension, cholesterol and perhaps plaque burden,’ said project lead Prof Rene Botnar from the Division of Imaging Sciences and Biomedical Engineering at King’s College London.
The build-up of fatty materials such as cholesterol leads to a chronic inflammatory response in the walls of arteries — collectively referred to as atherosclerosis.
As the main causal factor behind heart disease and stroke, atherosclerosis can be considered the biggest single cause of death in Western societies, so there is considerable impetus to develop effective surveillance.
However, current procedures either fail to visualise the artery walls (such as X-ray) or risk damaging artery walls (for example, intravascular ultrasound), thus they are not suitable for routine screening of atherosclerosis in large populations.
The new technology uses a contrast agent that attaches to the elastin (Elastin-Specific Magnetic Resonance Contrast Agent [ESMA]) which is abundant in arterial walls. Magnetic resonance imaging can then visualise localised elastin, and therefore plaque build-up, in 3D.
An initial trial was conducted over two years and investigated the build-up of plaque in the arteries of mice. Efforts are now underway to begin human clinical trials with the help of industrial partners Lantheus Medical Imaging and Phillips Healthcare.
The current work received funding for the British Heart Foundation, the Wellcome Trust and the EPSRC.