Evans NR, Tarkin JM, Chowdhury MM, et al. - Researchers assessed ¹⁸F-fluorodeoxyglucose (FDG) and 18F-sodium fluoride (NaF) uptake in culprit versus nonculprit carotid atheroma, spatial distributions of uptake, and (3) how macrocalcification affects this relationship. This study included a total of 26 individuals with acute ischemic stroke with ipsilateral carotid stenosis of ≥ 50% who underwent FDG-positron-emission tomography and NaF-positron-emission tomography. They evaluated tracer uptake applying maximum tissue-to-background ratios (TBRmax) and macrocalcification by using Agatston scoring. In vivo, this is the first study to indicate increased uptake of both FDG and NaF in culprit carotid plaques, with discrete distributions of pathophysiology affecting vulnerability. It was noted that these data have implications for the understanding of the natural history of the disease and for the clinical evaluation and management of carotid atherosclerosis.