J Cardiol. 2026 Jun 6:S0914-5087(26)00108-5. doi: 10.1016/j.jjcc.2026.06.002. Online ahead of print.
ABSTRACT
Atherosclerotic cardiovascular disease (ACVD) is increasingly recognized as a chronic inflammatory disorder involving complex interactions across vascular, metabolic, immune, and neurobiological systems. Conventional imaging modalities primarily assess anatomical features of atherosclerosis but provide limited insight into underlying inflammatory activity. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) enables noninvasive, quantitative assessment of metabolic activity associated with inflammation in vivo. Beyond vascular plaques, FDG-PET/CT can simultaneously evaluate inflammatory processes in adipose tissue, hematopoietic organs, and stress-related neural circuits, offering a systems-level perspective of disease pathophysiology. Accumulating evidence demonstrates that increased FDG uptake in these tissues is associated with cardiovascular risk, plaque instability, and adverse clinical outcomes. Moreover, FDG-PET/CT has emerged as a valuable tool for monitoring therapeutic responses, providing insights into the anti-inflammatory effects of pharmacological interventions. This review summarizes current evidence on the role of FDG-PET/CT in assessing multi-organ inflammatory processes in ACVD and highlights its potential to improve risk stratification and guide personalized therapeutic strategies through a systems-level imaging framework.
PMID:42252080 | DOI:10.1016/j.jjcc.2026.06.002