Francesco Cappelli1,2,3, Chiara Gallini4, Carlo Di Mario5, Egidio Natalino Costanzo4, Luca Vaggelli4, Francesca Tutino4, Alfonso Ciaccio4, Simone Bartolini5, Paola Angelotti6, Sabrina Frusconi6, Silvia Farsetti6, Giuseppe Vergaro7, Assuero Giorgetti7, Paolo Marzullo7, Dario Genovesi7, Michele Emdin8,7, Federico Perfetto6. 1. Tuscan Regional Amyloid Center, Azienda Ospedaliero Universitaria Careggi, Florence, Italy. cappellifrancesco@inwind.it. 2. Interventional Structural Cardiology Division, Careggi University Hospital, Florence, Italy. cappellifrancesco@inwind.it. 3. Department of Heart, Lung and Vessels, Intensive Cardiac Care Unit, Interventional Structural Cardiology Division, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy. cappellifrancesco@inwind.it. 4. Nuclear Medicine Division, Careggi University Hospital, Florence, Italy. 5. Interventional Structural Cardiology Division, Careggi University Hospital, Florence, Italy. 6. Tuscan Regional Amyloid Center, Azienda Ospedaliero Universitaria Careggi, Florence, Italy. 7. Fondazione Toscana Gabriele Monasterio, Pisa, Italy. 8. Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.
Abstract
BACKGROUND AND AIM: Either 99mTechnetium diphosphonate (Tc-DPD) or pyrophosphate (Tc-PYP) scintigraphy plays a relevant role in diagnosing transthyretin cardiac amyloidosis (CA), and labeled radiotracers have been extensively studied in diagnosing CA. Few studies have analyzed and validated 99mTc-Hydroxymethylene diphosphonate (Tc-HMDP). Our aim was to validate the diagnostic accuracy of Tc-HMDP total-body scintigraphy in a cohort of patients with biopsy-proven transthyretin CA. METHODS AND RESULTS: We retrospectively evaluated all patients undergoing 99mTc-HMDP total-body scintigraphy, in adjunct to a comprehensive diagnostic work-up for suspected CA. Sixty-five patients were finally diagnosed with CA, while it was excluded in 20 subjects with left ventricular hypertrophy of various etiologies. Twenty-six patients had AL-CA, 39 had TTR CA (16 TTRm, 23 TTRwt). At Tc-HMDP scintigraphy, 2 AL patients showed a Perugini score grade 1 heart uptake, while 24 showed no uptake. All TTR patients showed Tc-HMDP uptake, with three patients showing a Perugini score grade 1, 16 grade 2, and 20 grade 3, respectively. No uptake was observed in patients with left ventricular hypertrophy. A positive Tc-HMDP scintigraphy showed a 100% sensitivity and a 96% specificity for TTR CA identification. CONCLUSIONS: Tc-HMDP scintigraphy is as accurate as Tc-DPD or Tc-PYP, and may therefore de facto be considered a valuable tool for the diagnosis of TTR CA.
BACKGROUND AND AIM: Either 99mTechnetium diphosphonate (Tc-DPD) or pyrophosphate (Tc-PYP) scintigraphy plays a relevant role in diagnosing transthyretin cardiac amyloidosis (CA), and labeled radiotracers have been extensively studied in diagnosing CA. Few studies have analyzed and validated 99mTc-Hydroxymethylene diphosphonate (Tc-HMDP). Our aim was to validate the diagnostic accuracy of Tc-HMDP total-body scintigraphy in a cohort of patients with biopsy-proven transthyretin CA. METHODS AND RESULTS: We retrospectively evaluated all patients undergoing 99mTc-HMDP total-body scintigraphy, in adjunct to a comprehensive diagnostic work-up for suspected CA. Sixty-five patients were finally diagnosed with CA, while it was excluded in 20 subjects with left ventricular hypertrophy of various etiologies. Twenty-six patients had AL-CA, 39 had TTR CA (16 TTRm, 23 TTRwt). At Tc-HMDP scintigraphy, 2 ALpatients showed a Perugini score grade 1 heart uptake, while 24 showed no uptake. All TTRpatients showed Tc-HMDP uptake, with three patients showing a Perugini score grade 1, 16 grade 2, and 20 grade 3, respectively. No uptake was observed in patients with left ventricular hypertrophy. A positive Tc-HMDP scintigraphy showed a 100% sensitivity and a 96% specificity for TTR CA identification. CONCLUSIONS:Tc-HMDP scintigraphy is as accurate as Tc-DPD or Tc-PYP, and may therefore de facto be considered a valuable tool for the diagnosis of TTR CA.
Authors: Andor W J M Glaudemans; Ronald W J van Rheenen; Maarten P van den Berg; Walter Noordzij; Michel Koole; Hans Blokzijl; Rudi A J O Dierckx; Riemer H J A Slart; Bouke P C Hazenberg Journal: Amyloid Date: 2014-01-23 Impact factor: 7.141
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Authors: Giorgio Treglia; Andor W J M Glaudemans; Francesco Bertagna; Bouke P C Hazenberg; Paola A Erba; Raffaele Giubbini; Luca Ceriani; John O Prior; Luca Giovanella; Riemer H J A Slart Journal: Eur J Nucl Med Mol Imaging Date: 2018-04-23 Impact factor: 9.236