RT Journal Article SR Electronic T1 Vulnerable plaque detection: an unrealistic quest or a feasible objective with a clinical value? JF Heart JO Heart FD BMJ Publishing Group Ltd and British Cardiovascular Society SP 581 OP 589 DO 10.1136/heartjnl-2015-309060 VO 102 IS 8 A1 Christos V Bourantas A1 Hector M Garcia-Garcia A1 Ryo Torii A1 Yao-Jun Zhang A1 Mark Westwood A1 Tom Crake A1 Patrick W Serruys YR 2016 UL http://heart.bmj.com/content/102/8/581.abstract AB Evidence from the first prospective studies of coronary atherosclerosis demonstrated that intravascular imaging has limited accuracy in detecting lesions that are likely to progress and cause future events, and divided the scientific community into experts who advocate abandoning this quest and others who suggest intensifying our efforts improve and optimise the available imaging techniques. Although the current evidence may not justify the use of invasive or non-invasive imaging in the clinical setting for the detection of vulnerable, high-risk lesions, it is apparent that imaging has provided unique insights about plaque pathophysiology and evolution. Recent evidence indicates that both invasive and non-invasive imaging also provides useful prognostic information in patients with established coronary artery disease and in asymptomatic individuals and is likely to enable more accurate risk stratification. Future studies are anticipated to provide further insights about the value of novel hybrid imaging techniques, which are expected to enable complete assessment of plaque pathophysiology, in detecting vulnerable lesions and identifying high-risk patients that would benefit from new aggressive treatments targeting coronary atherosclerosis.