Abstract-To determine whether labeled antibodies against oxidized LDL (OxLDL) offer advantages for quantifying atherosclerosis, we compared in vivo aortic uptake of 125 I-labeled MDA2, a monoclonal antibody against malondialdehyde-lysine epitopes), atherosclerotic surface area, and aortic weight in Watanabe heritable hyperlipidemic and New Zealand White rabbits and in low density lipoprotein receptor-deficient (LDLR Ϫ/Ϫ ) and apolipoprotein E-deficient (apoE Ϫ/Ϫ ) mice. Absolute and specific uptakes of 125 I-MDA2 were significantly greater in plaque than in normal aortas. Uptake of 125 I-MDA2 significantly correlated with aortic weight and percent atherosclerotic surface area in rabbits and mice. To assess whether 125 I-MDA2 uptake reflects changes in lesion content of OxLDL, in a separate study, extensive atherosclerosis was induced in 4 groups of LDLR Ϫ/Ϫ mice by feeding them a high fat/cholesterol diet for 6 months. A baseline group was euthanized at this time. The remaining groups were fed "regression" diets (chow or chowϩ1% vitamin Eϩ0.05% vitamin C) or the high fat/cholesterol diet for 6 more months. When atherosclerosis was measured as percent surface area or aortic weight, there was strong progression in the high fat/cholesterol group, moderate progression in the chow group, and no progression in the chowϩvitamin Eϩvitamin C group compared with the baseline group. The 125 I-MDA2 method also yielded a significant increase in atherosclerosis in the high fat/cholesterol group but significant decreases in the chow and chowϩvitamin Eϩvitamin C groups. Immunocytochemistry showed fewer oxidation-specific epitopes in lesions from the chow and chowϩvitamin Eϩvitamin C groups. Thus, the uptake of 125 I-MDA2 correlates well with traditional measures of atherosclerosis but also reflects reduced plaque OxLDL content after hypocholesterolemic intervention.