99m Tc Bone-Avid Tracer Cardiac Scintigraphy: Role in Noninvasive Diagnosis of Transthyretin Cardiac Amyloidosis.
Yiu Ming KhorSarah A M CuddyVasvi SinghRodney H FalkMarcelo F Di CarliSharmila DorbalaPublished in: Radiology (2022)
Transthyretin cardiac amyloidosis (ATTR-CA) is an overlooked cause of heart failure, with substantial morbidity and mortality. The emergence of several novel therapies has fueled the interest in early and accurate diagnosis of ATTR-CA so that potentially life-saving pharmacologic therapy can be administered in a timely manner. The most promising imaging modality and biomarker is SPECT imaging with technetium 99m ( 99m Tc)-radiolabeled bone-seeking tracers, which have high specificity in the diagnosis of ATTR-CA, potentially obviating biopsy. In this article, the authors provide a focused review on the use of 99m Tc pyrophosphate (PYP), 3,3-diphosphono-1,2-propanodicarboxylic acid (DPD), and hydroxymethylene diphosphonate (HMDP) for diagnosis of ATTR-CA, present a systematic approach to interpretation of the scans, and highlight several common pitfalls to illustrate important diagnostic principles for accurate interpretation of these images. The authors indicate when to use endomyocardial biopsy for the diagnosis of cardiac amyloidosis and conclude with a section on quantitation of 99m Tc-PYP/DPD/HMDP imaging.
Keyphrases
- high resolution
- left ventricular
- heart failure
- computed tomography
- mass spectrometry
- magnetic resonance imaging
- multiple myeloma
- deep learning
- protein kinase
- bone mineral density
- machine learning
- atrial fibrillation
- liquid chromatography tandem mass spectrometry
- body composition
- magnetic resonance
- mesenchymal stem cells
- photodynamic therapy
- positron emission tomography
- high performance liquid chromatography
- fine needle aspiration
- contrast enhanced
- wild type
- liquid chromatography