This document discusses non-invasive imaging of vulnerable plaque using macrophage targeting contrast agents such as superparamagnetic iron oxide (SPIO) nanoparticles. SPIO nanoparticles are engulfed by macrophages and accumulate in inflamed plaques, shortening MRI relaxation times and allowing identification of active plaques. Studies in animal models demonstrate the feasibility of SPIO-enhanced MRI for detecting vulnerable plaque. However, limitations include the need to balance morphology and activity imaging, as well as poor resolution for coronary applications and the cost and complexity of SPIO injection and delayed imaging.