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Early microcalcification is a feature of coronary plaques with an increased propensity to rupture and to cause acute coronary syndromes. In this ex vivo imaging study of coronary artery specimens, the non-invasive imaging radiotracer, 18F-fluoride, was highly selective for hydroxyapatite deposition in atherosclerotic coronary plaque. Specifically, coronary 18F-fluoride uptake had a high signal to noise ratio compared with surrounding myocardium that makes it feasible to identify coronary mineralisation activity. Areas of 18F-fluoride uptake are associated with osteopontin, an inflammation-associated glycophosphoprotein that mediates tissue mineralisation, and Runt-related transcription factor 2, a nuclear protein involved in osteoblastic differentiation. These results suggest that 18F-fluoride is a non-invasive imaging biomarker of active coronary atherosclerotic mineralisation.

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Adult, Aged, Cadaver, Core Binding Factor Alpha 1 Subunit, Coronary Artery Disease, Durapatite, Female, Fluorine Radioisotopes, Humans, Male, Middle Aged, Organ Culture Techniques, Osteogenesis, Osteopontin, Plaque, Atherosclerotic, Positron Emission Tomography Computed Tomography, Spectrum Analysis, Raman, X-Ray Microtomography