STATIC AND WHOLE-BODY IMAGES VS. SPECT: TOGETHER OR SEPARATE FOR AN ACCURATE DETECTION OF TRANSTHYRETIN CARDIAC AMYLOIDOSIS
Abstract
Transthyretin cardiac amyloidosis (ATTR-CA) is a protein deposition disease that represents a challenge to be diagnosed by the practicing physician. As the gold standard method is not widely available correlations between biomarkers, electrocardiography, echocardiography, bone scintigraphy and free light chain dosage has proven to be a reliable alternative. Bone scintigraphy represents the corner stone for ATTR-CA detection; however, some patients cannot undergo all the required images for an easy and accurate diagnosis. Therefore, the aim of this study is to determine the bare minimum images that can be performed for an accurate diagnosis. Materials and methods: 80 patients that met the inclusion criteria were evaluated throw bone scintigraphy. Acquired images included: whole body bone scan (early and delayed), static followed by Single Photon Emission Computed Tomography (SPECT), if possible, centered on the thorax. Images were interpreted by visual scoring and semiquantitative methods. Results: 20 patients were diagnosed with ATTR cardiac amyloidosis by visual scoring, however not all of them underwent all the necessary images. Semiquantitative methods results were above the established threshold and therefore sustained the visual score. Nevertheless, ratio results differed between static and SPECT images. Conclusions: Ideally all type of images should be acquired for this type of patients, however, we determined that a minimum of whole-body ± static centered on the thorax images interpreted throw visual scoring and semiquantitative analysis can be enough if SPECT is not possible for a reliable diagnosis.
References
2. Witteles RM, Bokhari S, Damy T, et al. Screening for transthyretin amyloid cardiomyopathy in everyday practice. JACC Heart Fail 2019; 7(8): 709-716.
3. Garcia-Pavia P, Rapezzi C, Adler Y, et al. Diagnosis and treatment of cardiac amyloidosis: a position state-ment of the ESC Working Group on Myocardial and Pericardial Diseases. Eur Heart J 2021; 42(16): 1554-1568.
4. Ștefănescu C, Rusu V. De la fizica și biofizica radiofarmaceuticelor la imagini funcționale și moleculare. Iasi: Editura Tehnopress, 2007
5. Paolo Castellucci, Désirée Deandreis, Áron K. Krizsán Siroos Mirzaei John Prior Bernhard Sattler. Ghid european de medicină nucleară: publicație comună a EANM și UEMS/EBNM. Editura Medicală Universitară Iuliu Hațeganu, Cluj Napoca, 2021.
6. Ziessman H, O’Malley J, Thrall J. The Requisites. Nuclear Medicine fourth edition. 2014.
7. Redzepi B, Kamani CH, Maurizi N, Théaudin M, Prior J, Monney P. False Negative 99mTc-DPD Scintigraphy in pVal50Met (Val30Met) Hereditary Transthyretin Amyloidosis. CJC Open 2023; 6(2Part A): 118-121.
8. Garcia-Pavia P, Munoz-Beamud F, Casasnovas C on behalf of the Spanish Group for the Study and Treatment of the transthyretin Familial amyloid polyneuropathy (GETPAF-TTR). Recommendations regarding diagnosis and treatment of transthyretin Familial amyloid polyneuropathy. Med Clin Barc 2015; 145: 211-217.
9. Papathanasiou M, Carpinteiro A, Rischpler C, Hagenacker T, Rassaf T, Luedike P. Diagnosing cardiac amyloidosis in every-day practice: a practical guide for the cardiologist. Int J Cardiol Heart Vasc 2020; 28: 100519.
10. Hotta VT, Giorgi MCP, Fernandes F, Abduch MCD, Falcao AMGM, Mady C. Cardiac amyloidosis: non-invasive diagnosis. Rev Assoc Med Bras 2020; 66(3): 345-352.
11. Dorbala S, Bokhari S, Glaudemans AWJM, et al. 99mTechnetium-3,3-diphosphono-1,2-propano-dicarboxylic acid (DPD) and 99mTechnetium-hydroxymethylenediphosphonate (HMDP) Imaging for Transthyretin Cardiac Amyloidosis. ASNC and EANM Cardiac Amyloidosis Practice Points 2019.
12. Dorbala S, Ando Y, Bokhari S, Dispenzieri A, et al. ASNC/AHA/ASE/ EANM/ HFSA/ ISA/SCMR/SNMMI expert consensus recommendations for multimodality imaging in cardiac amyloidosis: Part 1 of 2-evidence base and standardized methods of imaging. J Nucl Cardiol. 2019 Dec; 26(6): 2065-2123 / Erratum in: J Nucl Cardiol. 2021; 28(4): 1761-1762.
13. Dorbala S, Ando Y, Bokhari S, Dispenzieri A, et al. Correction to: ASNC/AHA/ ASE/ EANM/ HFSA/ISA/SCMR/SNMMI Expert consensus recommendations for multimodality imaging in cardiac amyloidosis: Part 2 of 2-Diagnostic criteria and appropriate utilization. J Nucl Cardiol 2021; 28(4): 1763-1767.
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