Toru Awaya1,2, Ryogo Minamimoto3, Kentaro Iwama4, Shuji Kubota5, Masatoshi Hotta3, Risen Hirai6, Masaya Yamamoto5, Osamu Okazaki5, Hisao Hara5, Yukio Hiroi5, Michiaki Hiroe5, Masao Moroi7. 1. Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan. tooru.awaya@med.toho-u.ac.jp. 2. Division of Cardiovascular Medicine, Toho University Medical Center Ohashi Hospital, Tokyo, Japan. tooru.awaya@med.toho-u.ac.jp. 3. Division of Nuclear Medicine, National Center for Global Health and Medicine, Tokyo, Japan. 4. Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan. 5. Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan. 6. Department of Hematology, Internal medicine Tokyo-Kita Medical Center, Tokyo, Japan. 7. Division of Cardiovascular Medicine, Toho University Medical Center Ohashi Hospital, Tokyo, Japan.
Abstract
BACKGROUND: Light chain (AL) cardiac amyloidosis is associated with a poor prognosis. Diagnosing at an early stage is critical for treatment and the management of cardiac complication. PURPOSE: We aimed to evaluate the diagnostic performance of 99mTc-aprotinin images in patients with AL cardiac amyloidosis. METHODS AND RESULTS: 99mTc-aprotinin scintigraphy and endomyocardial biopsy were performed in 10 patients with suspected amyloidosis. Endomyocardial biopsy showed amyloid deposits in 5 of 10 patients. 99mTc-aprotinin (planer image) was positive in 4 of 5 patients who had amyloid deposits in endomyocardial biopsy. On the other hand, all 5 patients without amyloid deposits were negative in planer image. 99mTc-aprotinin (SPECT/CT image) was positive in all 5 patients who had amyloid deposits. CONCLUSIONS: 99mTc-aprotinin scintigraphy is valuable for the non-invasive diagnosis of AL cardiac amyloidosis.
BACKGROUND: Light chain (AL) cardiac amyloidosis is associated with a poor prognosis. Diagnosing at an early stage is critical for treatment and the management of cardiac complication. PURPOSE: We aimed to evaluate the diagnostic performance of 99mTc-aprotinin images in patients with AL cardiac amyloidosis. METHODS AND RESULTS:99mTc-aprotinin scintigraphy and endomyocardial biopsy were performed in 10 patients with suspected amyloidosis. Endomyocardial biopsy showed amyloid deposits in 5 of 10 patients. 99mTc-aprotinin (planer image) was positive in 4 of 5 patients who had amyloid deposits in endomyocardial biopsy. On the other hand, all 5 patients without amyloid deposits were negative in planer image. 99mTc-aprotinin (SPECT/CT image) was positive in all 5 patients who had amyloid deposits. CONCLUSIONS:99mTc-aprotinin scintigraphy is valuable for the non-invasive diagnosis of AL cardiac amyloidosis.
Entities:
Keywords:
99mTc-aprotinin scintigraphy; AL (light chain) cardiac amyloidosis; Nuclear imaging