Abstract
Positron emission tomography (PET) with (18)F-sodium fluoride ((18)F-NaF) has emerged as a promising non-invasive imaging modality to identify high-risk and ruptured atherosclerotic plaques. By visualizing microcalcification, (18)F-NaF PET holds clinical promise in refining how we evaluate coronary artery disease, shifting our focus from assessing disease burden to atherosclerosis activity. In this review, we provide an overview of studies that have utilized (18)F-NaF PET for imaging atherosclerosis. We discuss the associations between traditional coronary artery disease measures (risk factors) and (18)F-NaF plaque activity. We also present the data on the histological validation as well as show how (18)F-NaF uptake is associated with plaque morphology on intravascular and CT imaging. Finally, we discuss the technical challenges associated with (18)F-NaF coronary PET highlighting recent advances in this area.