Cardiac amyloidosis detection by early bisphosphonate (99mTc-HMDP) scintigraphy

To determine one or more indexes able to detect the presence of cardiac amyloidosis (CA) from planar scintigraphy images after injection of 99mTc-HMDP tracer and to identify the earliest acquisition time able to ensure an accurate diagnosis of amyloid transthyretin CA. A total of 38 patients were in...

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Bibliographic Details
Published in:Journal of nuclear cardiology 2022-02, Vol.29 (1), p.307-318
Main Authors: Santarelli, M.F., Genovesi, D., Positano, V., Di Sarlo, R., Scipioni, M., Giorgetti, A., Landini, L., Marzullo, P.
Format: Article
Language:English
Subjects:
Amyloid transthyretin (ATTR)
Amyloidosis
Amyloidosis - diagnostic imaging
Bone and Bones
Cardiac amyloidosis
Cardiology
Diphosphonates
Dynamic time-activity curves
Early 99mTc-HMDP scintigraphy
Humans
Imaging
Medicine
Medicine & Public Health
Nuclear Medicine
Original Article
Radiology
Radionuclide Imaging
Retention index
Scintigraphy
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Summary:To determine one or more indexes able to detect the presence of cardiac amyloidosis (CA) from planar scintigraphy images after injection of 99mTc-HMDP tracer and to identify the earliest acquisition time able to ensure an accurate diagnosis of amyloid transthyretin CA. A total of 38 patients were included: 18 subjects with a final diagnosis of ATTR-CA and 20 controls. Dynamic planar images of the anterior thorax were acquired, starting at intravenous injection of ≈ 700 MBq of 99mTc-HMDP. From time/activity curves (TAC) of regions of interest such as heart, vascular region, right ribcage, and soft tissues, several indices were considered. From the analysis, it resulted that both TACHeart/Bone(t) and RIheart–bone(t), for t > 6 minutes, well distinguish ATTR-CA patients from controls subjects. This is confirmed by the area under curves (AUC) analysis giving AUC values =.9 at t ≅ 6 minutes and AUC ≅ 1 for t > 10 minutes. The method proposed allows determining the presence of ATTR-CA, in an inexpensive manner both in terms of examination costs and time spent.
ISSN:1071-3581
1532-6551
DOI:10.1007/s12350-020-02239-5