Comparison of Static and Spect Images on Tc-99m-PYP Bone Scintigraphy in the Diagnosis of Cardiac Amyloidosis

Abstract

Amyloidosis is a systemic disease characterized by the extracellular accumulation of amyloid fibrils caused by misfolding of proteins. Cardiac amyloidosis has the worst prognosis of the type of organ involvements. The most common forms of cardiac amyloidosis are immunoglobulin light chain amyloidosis (AL) and transtretin (TTR) amyloidosis. The developing diagnostic methods give the clinician early diagnosis of cardiac amyloidosis. Scintigraphic imaging with Technetium (Tc-99m) labelled biphosponates may faciliate early detection of cardiac involvement and distinguish various forms of cardiac amyloidosis. Bone scintigraphy for evaluation of cardiac amyloidosis especially for ATTR type amyloidosis is one of the most sensitive imaging prosedures in recent years. In our study, we compared the 1st and 3rd hour planar and SPECT imaging to investigate the importance of the 3rd hour and the necessity of SPECT in cardiac amyloidosis (CA) imaging, which is one of the controversial topics from the Nuclear Medicine perspective.

Keywords

• cardiac amyloidosis
• Tc-99m PYP
• SPECT
• Planar
• Imaging
• scintigraphy.

References

1. Martinez-Naharro, A., Treibel, T. A., Abdel-Gadir, A., Bulluck, H., Zumbo, G., Knight, D. S., Kotecha, T., Francis, R., Hutt, D. F., Rezk, T., Rosmini, S., Quarta, C. C., Whelan, C. J., Kellman, P., Gillmore, J. D., Moon, J. C., Hawkins, P. N., & Fontana, M. (2017). Magnetic Resonance in Transthyretin Cardiac Amyloidosis. Journal of the American College of Cardiology, 70(4), 466–477. https://doi.org/10.1016/j.jacc.2017.05.053
2. Brownrigg, J., Lorenzini, M., Lumley, M., & Elliott, P. (2019). Diagnostic performance of imaging investigations in detecting and differentiating cardiac amyloidosis: a systematic review and meta-analysis. ESC heart failure, 6(5), 1041–1051. https://doi.org/10.1002/ehf2.12511
3. Dorbala, S., Cuddy, S., & Falk, R. H. (2020). How to Image Cardiac Amyloidosis: A Practical Approach. JACC. Cardiovascular imaging, 13(6), 1368–1383. https://doi.org/10.1016/j.jcmg.2019.07.015
4. Parry, T. L., Melehani, J. H., Ranek, M. J., & Willis, M. S. (2015). Functional Amyloid Signaling via the Inflammasome, Necrosome, and Signalosome: New Therapeutic Targets in Heart Failure. Frontiers in cardiovascular medicine, 2, 25. https://doi.org/10.3389/fcvm.2015.00025
5. Çavuşoğlu, Y., Özpelit, E., Çelik, A., İkitimur, B., Kayıkçıoğlu, M., Tokgözoğlu, L., Tüfekçioğlu, O., & Yılmaz, M. B. (2019). Cardiac amyloidosis: Recent advances in the diagnosis and therapy. Kardiyak amiloidoz: Tanı ve tedavide yenilikler. Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir, 47(Suppl 2), 1–34. https://doi.org/10.5543/tkda.2019.28035
6. Habib, G., Bucciarelli-Ducci, C., Caforio, A. L. P., Cardim, N., Charron, P., Cosyns, B., Dehaene, A., Derumeaux, G., Donal, E., Dweck, M. R., Edvardsen, T., Erba, P. A., Ernande, L., Gaemperli, O., Galderisi, M., Grapsa, J., Jacquier, A., Klingel, K., Lancellotti, P., Neglia, D., … Indian Academy of Echocardiography (2017). Multimodality Imaging in Restrictive Cardiomyopathies: An EACVI expert consensus document In collaboration with the "Working Group on myocardial and pericardial diseases" of the European Society of Cardiology Endorsed by The Indian Academy of Echocardiography. European heart journal. Cardiovascular Imaging, 18(10), 1090–1121. https://doi.org/10.1093/ehjci/jex034
7. Chen, W., Ton, V. K., & Dilsizian, V. (2018). Clinical Phenotyping of Transthyretin Cardiac Amyloidosis with Bone-Seeking Radiotracers in Heart Failure with Preserved Ejection Fraction. Current cardiology reports, 20(4), 23. https://doi.org/10.1007/s11886-018-0970-2
8. Treglia, G., Glaudemans, A. W. J. M., Bertagna, F., Hazenberg, B. P. C., Erba, P. A., Giubbini, R., Ceriani, L., Prior, J. O., Giovanella, L., & Slart, R. H. J. A. (2018). Diagnostic accuracy of bone scintigraphy in the assessment of cardiac transthyretin-related amyloidosis: a bivariate meta-analysis. European journal of nuclear medicine and molecular imaging, 45(11), 1945–1955. https://doi.org/10.1007/s00259-018-4013-4

9. Gillmore, J. D., Maurer, M. S., Falk, R. H., Merlini, G., Damy, T., Dispenzieri, A., Wechalekar, A. D., Berk, J. L., Quarta, C. C., Grogan, M., Lachmann, H. J., Bokhari, S., Castano, A., Dorbala, S., Johnson, G. B., Glaudemans, A. W., Rezk, T., Fontana, M., Palladini, G., Milani, P., … Hawkins, P. N. (2016). Nonbiopsy Diagnosis of Cardiac Transthyretin Amyloidosis. Circulation, 133(24), 2404–2412. https://doi.org/10.1161/CIRCULATIONAHA.116.021612.
10. Dorbala S, Bokhari S, Miller E, et. al. ASNC Practise Points, 99mTechnetium-Pyrophospahate Imaging for Transthyretin Cardiac Amyloidosis.
11. Bokhari, S., Castaño, A., Pozniakoff, T., Deslisle, S., Latif, F., & Maurer, M. S. (2013). (99m)Tc-pyrophosphate scintigraphy for differentiating light-chain cardiac amyloidosis from the transthyretin-related familial and senile cardiac amyloidoses. Circulation. Cardiovascular imaging, 6(2), 195–201. https://doi.org/10.1161/CIRCIMAGING.112.000132