Targeted molecular CT imaging of atherosclerosis and abdominal aortic aneurysm.
5 affiliations
- 1Technical University of Munich, Institute of Diagnostic and Interventional Radiology, Ismaninger Straße 22, 81675 Munich, Germany.
- 2Technical University of Munich, Institute of Cardiovascular Radiology and Nuclear Medicine, Lazarettstraße 36, 80636 Munich, Germany.
- 3Technical University of Munich, Munich Institute of Biomedical Engineering, Boltzmannstraße 11, 85748 Garching, Germany.
- 4Technical University of Munich, Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Paula-Hahn-Weinheimer-Straße 1, 85748 Garching, Germany.
- 5Technical University of Munich, Institute for Advanced Study, Lichtenbergstraße 2a, 85748 Garching, Germany.
Abstract
Atherosclerosis and abdominal aortic aneurysm (AAA) share the same pathological triad, which includes chronic inflammation, immune cell infiltration, and extracellular matrix (ECM) degradation. Both diseases are characterized by the fact that the disease process may not be diagnosed until a life-threatening event occurs. Current imaging methods diagnose these conditions by assessing the degree of stenosis of the blood vessel, the plaque burden, and the aneurysm diameter. Unfortunately, these methods are not sufficient to measure biological activity, which is important to determine if such potentially life-threatening events will occur and where they will occur. Molecular imaging, together with computed tomography (CT), might close this gap. CT offers several benefits: it is widely available, allows rapid acquisition, can be integrated into vascular workflows, and can provide quantitative signal readout, but its main use has been in the context of anatomical detail. Recent preclinical studies suggest that a shift may be occurring in this area. This review examines the use of molecular CT imaging for the diagnosis of atherosclerosis and AAA, systematically grouped by molecular target. There are three different approaches that are employed in the current literature. The most clinically advanced is the first, macrophage-targeted probes. The second, high-density lipoprotein (HDL)-mimetic nanoparticles, takes advantage of an endogenous lipoprotein pathway, but not an engineered ligand. The third, gold nanoparticles, which targeted elastin, yielded the most clinically relevant finding to date: ex vivo signal correlates inversely with aortic wall burst pressure, casting doubt on whether diameter is sufficient to assess for rupture. Comparable methods for targeting biomarkers with CT have not been developed, although magnetic resonance imaging (MRI) and nuclear imaging modalities can already target matrix metalloproteinase (MMP) activity, vascular cell adhesion molecule-1 (VCAM-1), and microcalcification. This is a space that could be very fruitful for future studies.
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BibTeX
@article{marchand2026targeted,
title = {{Targeted molecular CT imaging of atherosclerosis and abdominal aortic aneurysm.}},
author = {Jannis Marchand and Felix Stefan Reuter and Hannah Lichtmannegger and Keno Kyrill Bressem and Lisa Christine Adams and Franz Pfeiffer and Avan Kader and Marcus Richard Makowski},
journal = {Theranostics},
year = {2026},
month = aug,
doi = {10.7150/thno.137688},
url = {https://europepmc.org/article/MED/42909347},
note = {CC BY},
}
RIS
TY - JOUR
TI - Targeted molecular CT imaging of atherosclerosis and abdominal aortic aneurysm.
AU - Jannis Marchand
AU - Felix Stefan Reuter
AU - Hannah Lichtmannegger
AU - Keno Kyrill Bressem
AU - Lisa Christine Adams
AU - Franz Pfeiffer
AU - Avan Kader
AU - Marcus Richard Makowski
PY - 2026
DA - 2026/08/24
JO - Theranostics
DO - 10.7150/thno.137688
UR - https://europepmc.org/article/MED/42909347
AB - Atherosclerosis and abdominal aortic aneurysm (AAA) share the same pathological triad, which includes chronic inflammation, immune cell infiltration, and extracellular matrix (ECM) degradation. Both diseases are characterized by the fact that the disease process may not be diagnosed until a life-threatening event occurs. Current imaging methods diagnose these conditions by assessing the degree of stenosis of the blood vessel, the plaque burden, and the aneurysm diameter. Unfortunately, these methods are not sufficient to measure biological activity, which is important to determine if such potentially life-threatening events will occur and where they will occur. Molecular imaging, together with computed tomography (CT), might close this gap. CT offers several benefits: it is widely available, allows rapid acquisition, can be integrated into vascular workflows, and can provide quantitative signal readout, but its main use has been in the context of anatomical detail. Recent preclinical studies suggest that a shift may be occurring in this area. This review examines the use of molecular CT imaging for the diagnosis of atherosclerosis and AAA, systematically grouped by molecular target. There are three different approaches that are employed in the current literature. The most clinically advanced is the first, macrophage-targeted probes. The second, high-density lipoprotein (HDL)-mimetic nanoparticles, takes advantage of an endogenous lipoprotein pathway, but not an engineered ligand. The third, gold nanoparticles, which targeted elastin, yielded the most clinically relevant finding to date: ex vivo signal correlates inversely with aortic wall burst pressure, casting doubt on whether diameter is sufficient to assess for rupture. Comparable methods for targeting biomarkers with CT have not been developed, although magnetic resonance imaging (MRI) and nuclear imaging modalities can already target matrix metalloproteinase (MMP) activity, vascular cell adhesion molecule-1 (VCAM-1), and microcalcification. This is a space that could be very fruitful for future studies.
SN - 1838-7640
ER -