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Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Wild-type (senile) amyloidosis other imaging findings

Introduction

Overview

Overview

Bone-avid tracers, such as 99mTc-DPD (technetium-3,3-diphosphono-1,2-propanodicar-boxylic acid), 99mTc-PYP (technetium-pyrophosphate), and 99mTc-HMDP [technetium-hydroxymethylene diphosphonate (Tc-HMDP)] have been implicated to have high sensitivity and specificity for diagnosing cardiac amyloidosis and differentiating it from other cardiomyopathies with HFpEF. Combination of grade 2 or 3 cardiac uptake on a bone-avid tracer scan in the setting of absent monoclonal protein by serum immunofixation electrophoresis (IFE), urine IFE, and serum free light chain assay is diagnostic of wild-type (senile) cardiac amyloidosis.

Other Imaging Findings

Other Imaging Findings

Nuclear Imaging

  • Bone-avid tracers, such as 99mTc-DPD (technetium-3,3-diphosphono-1,2-propanodicar-boxylic acid), 99mTc-PYP (technetium-pyrophosphate), and 99mTc-HMDP [technetium-hydroxymethylene diphosphonate (Tc-HMDP)] have been implicated to have high sensitivity and specificity for diagnosing cardiac amyloidosis and differentiating it from other cardiomyopathies with HFpEF.[1][2]
  • Combination of grade 2 or 3 cardiac uptake on a bone-avid tracer scan in the setting of absent monoclonal protein by serum immunofixation electrophoresis (IFE), urine IFE, and serum free light chain assay is diagnostic of wild-type (senile) cardiac amyloidosis.[3]
  • Nuclear imaging with 99mTc-DPD and 99mTc-PYP can show cardiac involvement prior to any overt echocardiographic abnormalities and can foresee major adverse cardiac events.[4][5][6][7]
References

References

  1. ↑ Enrica Perugini, Pier Luigi Guidalotti, Fabrizio Salvi, Robin M. T. Cooke, Cinzia Pettinato, Letizia Riva, Ornella Leone, Mohsen Farsad, Paolo Ciliberti, Letizia Bacchi-Reggiani, Francesco Fallani, Angelo Branzi & Claudio Rapezzi (2005). “Noninvasive etiologic diagnosis of cardiac amyloidosis using 99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid scintigraphy”. Journal of the American College of Cardiology. 46 (6): 1076–1084. doi:10.1016/j.jacc.2005.05.073. PMID 16168294. Unknown parameter |month= ignored (help)
  2. ↑ Sabahat Bokhari, Rachelle Morgenstern, Richard Weinberg, Mona Kinkhabwala, Demetrios Panagiotou, Adam Castano, Albert DeLuca, Andrew Kontak, Zhezhen Jin & Mathew S. Maurer (2018). “Standardization of (99m)Technetium pyrophosphate imaging methodology to diagnose TTR cardiac amyloidosis”. Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology. 25 (1): 181–190. doi:10.1007/s12350-016-0610-4. PMID 27580616. Unknown parameter |month= ignored (help)
  3. ↑ Julian D. Gillmore, Mathew S. Maurer, Rodney H. Falk, Giampaolo Merlini, Thibaud Damy, Angela Dispenzieri, Ashutosh D. Wechalekar, John L. Berk, Candida C. Quarta, Martha Grogan, Helen J. Lachmann, Sabahat Bokhari, Adam Castano, Sharmila Dorbala, Geoff B. Johnson, Andor W. J. M. Glaudemans, Tamer Rezk, Marianna Fontana, Giovanni Palladini, Paolo Milani, Pierluigi L. Guidalotti, Katarina Flatman, Thirusha Lane, Frederick W. Vonberg, Carol J. Whelan, James C. Moon, Frederick L. Ruberg, Edward J. Miller, David F. Hutt, Bouke P. Hazenberg, Claudio Rapezzi & Philip N. Hawkins (2016). “Nonbiopsy Diagnosis of Cardiac Transthyretin Amyloidosis”. Circulation. 133 (24): 2404–2412. doi:10.1161/CIRCULATIONAHA.116.021612. PMID 27143678. Unknown parameter |month= ignored (help)
  4. ↑ Claudio Rapezzi, Candida C. Quarta, Pier Luigi Guidalotti, Cinzia Pettinato, Stefano Fanti, Ornella Leone, Alessandra Ferlini, Simone Longhi, Massimiliano Lorenzini, Letizia Bacchi Reggiani, Christian Gagliardi, Pamela Gallo, Caterina Villani & Fabrizio Salvi (2011). “Role of (99m)Tc-DPD scintigraphy in diagnosis and prognosis of hereditary transthyretin-related cardiac amyloidosis”. JACC. Cardiovascular imaging. 4 (6): 659–670. doi:10.1016/j.jcmg.2011.03.016. PMID 21679902. Unknown parameter |month= ignored (help)
  5. ↑ Muhammad Haq, Sumeet Pawar, John L. Berk, Edward J. Miller & Frederick L. Ruberg (2017). “Can (99m)Tc-Pyrophosphate Aid in Early Detection of Cardiac Involvement in Asymptomatic Variant TTR Amyloidosis?”. JACC. Cardiovascular imaging. 10 (6): 713–714. doi:10.1016/j.jcmg.2016.06.003. PMID 27568122. Unknown parameter |month= ignored (help)
  6. ↑ Adam Castano, Muhammad Haq, David L. Narotsky, Jeff Goldsmith, Richard L. Weinberg, Rachelle Morgenstern, Ted Pozniakoff, Frederick L. Ruberg, Edward J. Miller, John L. Berk, Angela Dispenzieri, Martha Grogan, Geoffrey Johnson, Sabahat Bokhari & Mathew S. Maurer (2016). “Multicenter Study of Planar Technetium 99m Pyrophosphate Cardiac Imaging: Predicting Survival for Patients With ATTR Cardiac Amyloidosis”. JAMA cardiology. 1 (8): 880–889. doi:10.1001/jamacardio.2016.2839. PMID 27557400. Unknown parameter |month= ignored (help)
  7. ↑ Arnt V. Kristen, Sabine Haufe, Stefan O. Schonland, Ute Hegenbart, Philipp A. Schnabel, Christoph Rocken, Stefan Hardt, Peter Lohse, Anthony D. Ho, Uwe Haberkorn, Thomas J. Dengler, Klaus Altland & Hugo A. Katus (2013). “Skeletal scintigraphy indicates disease severity of cardiac involvement in patients with senile systemic amyloidosis”. International journal of cardiology. 164 (2): 179–184. doi:10.1016/j.ijcard.2011.06.123. PMID 21764155. Unknown parameter |month= ignored (help)

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sabawoon Mirwais, M.B.B.S, M.D.[2]