Targeted Imaging for Cell Death in Cardiovascular Disorders

Cell death is desirable in cancer cells and undesirable in organs with limited regenerative potential, like the heart. Cell death comes in many forms, but only apoptosis and to a lesser degree necrosis is currently relevant to the clinical imager. Noninvasive imaging of cell death is an attractive option to understand pathophysiology, track disease activity, and evaluate response to intervention. Apoptosis seems to be the most promising target for imaging cell death, because it could be reversible and might be modulated with interventions. Molecular, nuclear, optical, or magnetic resonance imaging–based methods have been developed to identify intermediate steps in the apoptosis cascade. Animal studies show promising results for noninvasive imaging in various cardiovascular diseases. Human studies have shown feasibility, but clinical use is yet inconclusive. Newer technologies offer promise, especially for tracking apoptosis in evaluation of novel therapeutic interventions.