Over a hump for imaging atherosclerosis: nanobodies visualize vascular cell adhesion molecule-1 in inflamed plaque.

The “Holy Grail” in molecular imaging of cardiovascular disease is sensitive, specific, economic, and radiationfree detection of atheromata prone to produce thrombotic complications.1,2 In this issue of Circulation Research, Broisat et al3 describe another step on the path toward noninvasive molecular imaging of inflammation in atherosclerotic plaque. Although still unproven, the early detection of trouble looming ahead could trigger steps for intervention, possibly involving the aggressive modulation of risk factors. Imaging might even help to define individual risk and to guide appropriate local therapy.4