Is the plaque-biology assessment the future of imaging?

Javier Escaned and Thomas Keeble discuss how near-infrared spectroscopy (NIRS) is emerging as a valuable tool to assess plaque biology in coronary arteries by measuring lipid content, a key marker of plaque vulnerability. Unlike traditional imaging that mainly describes structure, NIRS identifies high-risk, lipid-rich plaques using the Lipid Core Burden Index (LCBI), helping clinicians determine which lesions are most likely to cause future cardiac events or are responsible for acute coronary syndromes. This information enables more personalised decision-making in the cath lab, such as selecting the culprit vessel, adjusting stenting strategies, or extending treatment to cover nearby high-risk areas. Beyond procedures, detecting vulnerable plaques signals a higher-risk patient overall, encouraging more aggressive systemic management of cardiovascular risk factors.

This interview was filmed at EuroPCR 2026: see more videos here.