Cardiovascular imaging has recently expanded to the search for unstable plaques at high risk of rupturing and causing acute coronary events. A vulnerable plaque has been described histologically as a plaque with a large lipid core, a thin fibrous cap, and inflammation at the margins of the plaque. One of the most interesting recent findings is the discovery that plaques exhibiting high-risk characteristics may be associated with inducible myocardial ischemia even in the absence of luminal obstruction. Currently, anatomical and functional imaging of coronary atherosclerosis can be performed with computed tomography angiography and positron emission tomography, as briefly reviewed in this chapter. Keywords Vulnerable plaque imaging Sodium fluoride (¹⁸F-NaF) Chemo/radiation cardiac toxicity

Positron emission tomography (PET) is a non-invasive imaging technique that employs positron-emitting radionuclides labelled to biological molecules. Unlike other imaging techniques, such as computer tomography (CT) and magnetic resonance imaging (MRI) that provide anatomical or structural information, PET allows obtaining unique quantitative information of important biologic processes in vivo (e.g. myocardial perfusion and metabolism, inflammation, innervation, receptor density).

To recognize and develop skills to troubleshoot artifacts caused by incorrect emission-transmission alignment, patient or cardiac motion, and other sources of attenuation correction errors. To recognize normal variants associated with different radiotracers on myocardial perfusion PET imaging. To develop skills to perform quality control of PET images, verify accuracy of time activity curves, and quantitative data.

To understand the complexities of cardiac toxicity arising from chemotherapy and radiation therapy through detailed case studies. To emphasize the importance of early detection and comprehensive management of cardiac toxicity to improve patient outcomes. To equip healthcare professionals with advanced imaging techniques and clinical observations to identify, monitor, and mitigate cardiac toxicity in patients undergoing cancer therapies.

To learn how to use PET imaging to exclude infection or inflammation. To recognize imaging patterns that may indicate infection rather than inflammation. To learn how to integrate correlative imaging findings into the interpretation of PET images. To learn how to use PET imaging to guide management.

Early diagnosis of endocarditis has an important prognostic value because a delay in antibiotic therapy and cardiac surgery may adversely affect clinical outcome. However, its diagnosis remains a challenging one.