Non-invasive detection and differentiation of cardiac amyloidosis using 99mTc-pyrophosphate scintigraphy and 11C-Pittsburgh compound B PET imaging. (1st October 2020)

• Record Type: Journal Article
• Authors: Takasone, Ken; Katoh, Nagaaki; Takahashi, Yusuke; Abe, Ryuta; Ezawa, Naoki; Yoshinaga, Tsuneaki; Yanagisawa, Shin; Yazaki, Masahide; Oguchi, Kazuhiro; Koyama, Jun; Sekijima, Yoshiki
• Is Part Of: Amyloid. Volume 27:Number 4(2020)
• Page Start: 266
• Page End: 274
• Publication Date: 2020-10-01
• Subjects: Pyrophosphate scintigraphy -- Pittsburgh compound B PET -- light-chain amyloidosis -- hereditary transthyretin amyloidosis -- wild-type transthyretin amyloidosis; Amyloidosis -- Periodicals; 616.3995
• DOI: 10.1080/13506129.2020.1798223
• Languages: English
• ISSNs: 1350-6129

Abstract

Abstract: Purpose: To investigate the utility of the combined use of 11 C-Pittsburgh compound B ( 11 C-PiB) positron emission tomography (PET) imaging and 99m Tc-pyrophosphate ( 99m Tc-PYP) scintigraphy for detection and differentiation of three major types of cardiac amyloidosis, i.e. immunoglobulin light chain (AL), hereditary transthyretin (ATTRv), and wild-type transthyretin (ATTRwt) amyloidosis. Methods: Whole-body 11 C-PiB PET and 99m Tc-PYP scintigraphy were performed in 17 patients with AL amyloidosis, 22 patients with ATTRv, and eight patients with ATTRwt amyloidosis. The correlations between organ involvement and the uptake of 11 C-PiB and 99m Tc-PYP were analyzed in each patient. Results: Cardiac amyloidosis was detectable by 99m Tc-PYP scintigraphy or 11 C-PiB PET in all systemic amyloidosis patients with cardiac involvement. 99m Tc-PYP scintigraphy and 11 C-PiB PET showed an interesting complementary relation. Strict combination of positive 11 C-PiB and negative 99m Tc-PYP uptake (PiB pattern) was observed in all AL amyloidosis patients with cardiac involvement. In contrast, strict combination of positive 99m Tc-PYP and negative 11 C-PiB uptake (PYP pattern) was observed in all ATTRwt amyloidosis patients with cardiac involvement. ATTRv amyloidosis patients with cardiac involvement were divided into two groups: PiB pattern or PYP pattern. All of the early-onset V30M (p.V50M) ATTRv patients showed the PiB pattern, whereas all of the late-onset V30M and non-V30M ATTRv patients showed the PYP pattern. Conclusions: All three major types of cardiac amyloidosis can be detected and differentiated non-invasively by combined use of the two amyloid imaging methods and TTR gene testing.