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To facilitate first-in-human studies using extracellular MPO activity as a molecular imaging target to identify high-risk atherosclerotic plaque, we describe [\n                    <jats:sup>68<\/jats:sup>\n                    Ga]Ga-IEMA, a NODAGA-based positron emission tomography (PET) radiotracer that provides an index for extracellular MPO activity. Synthesis of [\n                    <jats:sup>68<\/jats:sup>\n                    Ga]Ga-IEMA was achieved in five steps and with high radiolabelling efficiency. [\n                    <jats:sup>68<\/jats:sup>\n                    Ga]Ga-IEMA self-oligomerized and bound to proteins upon exposure to enzymatically active MPO, did not cross-cell membranes and was stable in human serum in vitro, while [\n                    <jats:sup>68<\/jats:sup>\n                    Ga]Ga-IEMA had favorable blood kinetics and stability in circulation in vivo. [\n                    <jats:sup>68<\/jats:sup>\n                    Ga]Ga-IEMA PET imaging in a mouse model of plaque instability revealed enhanced signal in unstable compared with stable plaque and plaque-free arteries. These data indicate that [\n                    <jats:sup>68<\/jats:sup>\n                    Ga]Ga-IEMA is a promising translational candidate for the non-invasive identification of high-risk atherosclerotic plaques and the evaluation of therapies targeting arterial inflammation.\n                  <\/jats:p>","DOI":"10.1038\/s44303-026-00156-9","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T05:30:52Z","timestamp":1775539852000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Development and validation of an activatable PET radiotracer reporting extracellular myeloperoxidase activity for the detection of unstable atherosclerotic plaque"],"prefix":"10.1038","volume":"4","author":[{"given":"George P.","family":"Keeling","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoying","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiyu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Chaher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo E.","family":"Andia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergey","family":"Tumanov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Golda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed M.","family":"Chowdhury","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prakash","family":"Saha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lefteris","family":"Livieratos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Nadel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Stocker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alkystis","family":"Phinikaridou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"156_CR1","doi-asserted-by":"publisher","first-page":"e93","DOI":"10.1161\/CIR.0000000000001123","volume":"147","author":"CW Tsao","year":"2023","unstructured":"Tsao, C. 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