Abstract

Building on decades of technological advances and imaging experience, during which noninvasive imaging of cardiac structure and function, myocardial perfusion and viability, and noncoronary vascular pathology have become intimately entwined in routine clinical practice, advanced imaging techniques are now poised to deliver noninvasive coronary arteriograms and to delineate the coronary artery wall in exquisite detail. At the same time that these highly promising methods for anatomic imaging at the macroscopic level are creating great excitement among physicians, their patients, and the public, a quieter imaging revolution is underway with steady progress in detecting and tracking fundamental biological processes at the cellular and subcellular levels. In the era of genomic research, molecular biology, and stem cell therapies, these methods have great potential to accelerate understanding of basic pathophysiological processes in animals and humans and to develop new tools for early diagnosis and drug development. Cardiovascular molecular imaging is taking hold. See p 1800 Molecular imaging is the science of visually representing, characterizing, and quantifying cellular/subcellular biological processes in intact organisms. These processes include gene expression, protein–protein interaction, signal transduction, cellular metabolism, and both intracellular and intercellular trafficking. Molecular imaging has the potential to quantify these events, to monitor multiple events simultaneously, to localize these events in 3 dimensions, and to monitor these events serially. Thus, biological processes can be identified and studied in time and space, providing “4-dimensional” information. The emergence of molecular imaging has coincided with and has been made possible by the enormous progress in molecular biology, cell biology, and transgenic animal models, as well as the development of imaging probes that are specific, reproducible, and quantifiable.1 Molecular imaging was once the sole domain of nuclear medicine, with tracers developed for both positron emission tomography (PET) and single photon emission computed tomography (SPECT). Examples include antimyosin antibodies for …

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