“…Finally, lipid-binding proteins such as annexin A5 (7,37) that recognize exposed phosphatidylserine on apoptotic cells can also be exploited to image dying cells, including apoptotic macrophage foam cells in atherosclerotic lesions. However, because phosphatidylserine can be exposed on any dying or damaged cell, including activated platelets; ischemic, stressed, or traumatized cardiomyocytes; myoblasts; immune cells; and erythrocytes (38,39), opportunities for misinterpretation of data once again arise. Although 99m Tc-EC20 will admittedly image virtually any site of active inflammation, its ease of synthesis and radiolabeling, excellent tissue penetration, and rapid clearance from FR-negative tissues (due to its small size and water solubility (16,25), lack of toxicity or immunogenicity (12,24), and specificity for an abundant cell type in atherosclerotic lesions [macrophages] (12,14,23)) renders it a possible candidate for further evaluation.…”