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. 2018 Jun 12;8:8992. doi: 10.1038/s41598-018-26696-8

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© The Author(s) 2018

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Human carotid endarterectomy sample images reveal pathognomonic features of plaques (a) photograph is taken with a smart phone, (b) a confirmatory IVIS-200 image yields high radioluminescent signal at the ¹⁸F-FDG injection site during the sample is placed under a scintillating LSO crystal screen (45 second exposure time at 8 × 8 binning). The sample is rotated to highlight the location of the ¹⁸F-FDG accumulation. (c) CRI image of (i-1) control sample (pre-injection) shows no radioluminescent signal with medium 4 × 4 binning; however, (ii-1) post-injection of 50 µCi ¹⁸F-FDG shows an immediate increase of radioluminescent signal with 2 × 10⁴ photons at small 1 × 1 binning, (iii-1) 6 × 10⁴ photons at medium 4 × 4 binning. A custom written edge detection software outlines the area with this high radioluminescent signal. (i-2) No edges are detected in the control, representing the absence of ¹⁸F-FDG. (ii-2, iii-2) Post-injection image shows a distinctive edge at the deposition of ¹⁸F-FDG. A custom written software highlights the contour of the ¹⁸F-FDG signal distribution. (i-3) No contour is detected in the control sample where (ii-3, iii-3) post-injection area of the atherosclerotic plaque showed well defined contour pattern. X and Y axes in these images (i-1, ii-1, iii-1, i-2, ii-2, iii-2, i-3, ii-3, iii-3) represent the effective active imaging resolutions in pixels. 3D plot of the radioluminescent signal intensity shows (i-4) a flat distribution of signal in the control, and (ii-4, iii-4) a sharp peak of radioluminescent signal at the post-injection area. Statistically based on CRI images of (d) all human carotid endarterectomy samples show a 60-fold higher radioluminescent signal at the atherosclerotic plaque area compared to the control (45 second exposure time with binning of 4 × 4); (e) a linear relationship is identified between radioluminescent signal intensity vs. exposure time. Similarly the confirmatory IVIS-200 images (f) yield a 62-fold brighter radioluminescent signal compared to the control (45 second exposure with binning of 4 × 4); (g) a linear relationship is established between radioluminescent signal intensity vs. exposure time. All results statistically significant (P < 0.05). Figure 4 is already published in the SNMMI Annual Conference Abstract¹⁹.