Performance of 99m Tc-aprotinin scintigraphy for diagnosing light chain (AL) cardiac amyloidosis confirmed by endomyocardial biopsy
Conclusions99mTc-aprotinin scintigraphy is valuable for the non-invasive diagnosis of AL cardiac amyloidosis.
AbstractNuclear medicine bone scans differentiate ATTR cardiomyopathy (ATTR-CM) from light chain cardiac amyloidosis and other myocardial disorders, helping to make the diagnosis without biopsy. Standard bone scans are not absolutely quantitative, so are assessed by comparing the heart to other tissues. The standard visual scoring system compares heart to bone. This accurately diagnoses ATTR-CM and has been validated in a multicenter study, but has limitations. Semiquantitative techniques including heart/contralateral thorax (H/CL) and heart/whole body ratio (H/WB) improve on visual scoring but still rely on extracardiac s...
Condition: Cardiac Amyloidosis Intervention: Diagnostic Test: Spect scan with mTc99-PYP Sponsor: Tel-Aviv Sourasky Medical Center Not yet recruiting
In this report, we focus on an inconclusive study case as a potential pitfall of 99mTc-PYP scintigraphy and discuss the interpretation of 99mTc-PYP scintigraphy findings with using both planar and SPECT/CT imaging for improvement of diagnostic accuracy for ATTR cardiac amyloidosis.
ConclusionQuantitative99mTc-DPD SPECT/CT in suspected ATTR CA patients is feasible and allows for a more accurate assessment of myocardial uptake.
The American Society of Nuclear Cardiology (ASNC) has published a set of recommendations...Read more on AuntMinnie.comRelated Reading: Imaging groups oppose cuts in myocardial PET rates ASNC names Beanlands as president ASNC releases new guidelines for SPECT MPI SNMMI, ASNC offer guidelines for myocardial perfusion imaging with PET ASNC, SNMMI advise on cardiac sarcoidosis
Transthyretin (TTR) amyloidosis is a debilitating systemic disease often associated with symptomatic cardiac involvement. Cardiac amyloidosis remains underappreciated as its diagnosis has been challenging. Recently, Technetium99-m pyrophosphate (Tc-PYP) single-photon emission computed tomography (SPECT) imaging has emerged as a reliable modality to diagnose patients with TTR cardiac amyloidosis. However, there are no clear guidelines regarding which patients should be referred for Tc-PYP imaging.
AbstractIntroductionAssessment of myocardial uptake of Tc-99m-pyrophosphate (Tc-99m PYP) is pivotal in distinguishing transthyretin-associated cardiac amyloidosis (ATTR) from light chain amyloid (AL). It is often difficult to differentiate myocardial uptake from blood pool radioactivity with planar imaging or SPECT. We studied whether simultaneous dual-isotope Tc-99m PYP/Tl-201 SPECT improves assessment of Tc-99m PYP uptake compared to single-isotope SPECT.MethodsSimultaneous Tc-99m PYP/Tl-201 dual-isotope SPECT was acquired in 112 patients studied for possible cardiac amyloidosis. Visual interpretation was performed by tw...