Oxford team review: pericoronary fat imaging turns coronary inflammation into a quantifiable metric, with FAI Score falling after lipid-lowering, biologics and radiotherapy
This review by a University of Oxford group synthesises the anatomical and physiological basis of pericoronary adipose tissue (PCAT) as a biosensor of coronary inflammation, explains how the standardised Fat Attenuation Index (FAI) Score corrects for technical, anatomical and biological variability and predicts MACE, reviews the role of artificial intelligence in automated segmentation and multi-parametric risk modelling, and compiles evidence that FAI falls after statins, anti-oxLDL antibodies, anti-TNF biologics, radiotherapy and cardiometabolic agents, concluding that PCAT imaging may complement traditional risk factors and plaque metrics while the evidence remains evolving.