Cardiac amyloidosis detection by early bisphosphonate (99mTc-HMDP) scintigraphy

• Published in: Journal of nuclear cardiology Vol. 29; no. 1; pp. 307 - 318
• Main Authors: Santarelli, M.F., Genovesi, D., Positano, V., Di Sarlo, R., Scipioni, M., Giorgetti, A., Landini, L., Marzullo, P.
• Format: Journal Article
• Language: English
• Published: Cham Elsevier Inc 01.02.2022; Springer International Publishing; Springer Nature B.V
• Subjects: Amyloid transthyretin (ATTR); Amyloidosis; Amyloidosis - diagnostic imaging; Bone and Bones; Cardiac amyloidosis; Cardiology; Diphosphonates; Dynamic time-activity curves; Early 99mTc-HMDP scintigraphy; Humans; Imaging; Medicine; Medicine & Public Health; Nuclear Medicine; Original Article; Radiology; Radionuclide Imaging; Retention index; Scintigraphy; Dynamic time-activity curves; Amyloid transthyretin (ATTR); Early 99mTc-HMDP scintigraphy; AL; ROI; ATTR; AUC; nRMSE; HMDP; Retention index; Cardiac amyloidosis; RI; TAC; SEM; CA
• ISSN: 1071-3581; 1532-6551; 1532-6551
• DOI: 10.1007/s12350-020-02239-5

To determine one or more indexes able to detect the presence of cardiac amyloidosis (CA) from planar scintigraphy images after injection of 99mTc-HMDP tracer and to identify the earliest acquisition time able to ensure an accurate diagnosis of amyloid transthyretin CA. A total of 38 patients were included: 18 subjects with a final diagnosis of ATTR-CA and 20 controls. Dynamic planar images of the anterior thorax were acquired, starting at intravenous injection of ≈ 700 MBq of 99mTc-HMDP. From time/activity curves (TAC) of regions of interest such as heart, vascular region, right ribcage, and soft tissues, several indices were considered. From the analysis, it resulted that both TACHeart/Bone(t) and RIheart–bone(t), for t > 6 minutes, well distinguish ATTR-CA patients from controls subjects. This is confirmed by the area under curves (AUC) analysis giving AUC values =.9 at t ≅ 6 minutes and AUC ≅ 1 for t > 10 minutes. The method proposed allows determining the presence of ATTR-CA, in an inexpensive manner both in terms of examination costs and time spent.