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caliber to the human coronary artery. Twenty‐four hours after an intravenous injection of Prosense VM110, a NIRF molecular imaging agent that reports on cathepsin protease activity in atheroma, in vivo intravascular NIRF‐OCT was performed. NIRF revealed augmented protease activity in OCT‐defined atheroma, with substantial inflammation heterogeneity seen across atheroma (a,d). The OCT catheter is seen in the middle of the image; the NIRF signal intensity (representing quantitative protease inflammatory activity) is represented by a color scale bar mapped on to the luminal border. The NIRF‐OCT findings were confirmed by histology (H&E, middle column b and e), and cathepsin B immunohistochemistry (right column, c and f).

      Source: Yoo et al. 2011 [135]. Reproduced with permission of Nature Publishing Group.

      Clinical translation

       NIRF‐OCT imaging system

      Recently, investigators performed the first human coronary imaging studies of patients using a clinically approved NIRF‐OCT catheter [147]. While this catheter was used to detect plaque NIR autofluorescence, or NIRAF (no imaging agent was injected), the ability to safely acquired NIRF‐OCT images is a major step forward in realizing intracoronary molecular imaging. NIRAF itself may indicated the presence of intraplaque hemorrhage [148].

       NIRF molecular imaging agents

       Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology

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