Imaging cardiac amyloidosis: a pilot study using F-florbetapir positron emission tomography

Dorbala, Sharmila; Vangala, Divya; Semer, James; Strader, Christopher; Bruyere, John; Carli, Marcelo; Moore, Stephen; Falk, Rodney
September 2014
European Journal of Nuclear Medicine & Molecular Imaging;Sep2014, Vol. 41 Issue 9, p1652
Academic Journal
Purpose: Cardiac amyloidosis, a restrictive heart disease with high mortality and morbidity, is underdiagnosed due to limited targeted diagnostic imaging. The primary aim of this study was to evaluate the utility of F-florbetapir for imaging cardiac amyloidosis. Methods: We performed a pilot study of cardiac F-florbetapir PET in 14 subjects: 5 control subjects without amyloidosis and 9 subjects with documented cardiac amyloidosis. Standardized uptake values (SUV) of F-florbetapir in the left ventricular (LV) myocardium, blood pool, liver, and vertebral bone were determined. A F-florbetapir retention index (RI) was computed. Mean LV myocardial SUVs, target-to-background ratio (TBR, myocardial/blood pool SUV ratio) and myocardial-to-liver SUV ratio between 0 and 30 min were calculated. Results: Left and right ventricular myocardial uptake of F-florbetapir were noted in all the amyloid subjects and in none of the control subjects. The RI, TBR, LV myocardial SUV and LV myocardial to liver SUV ratio were all significantly higher in the amyloidosis subjects than in the control subjects (RI median 0.043 min, IQR 0.034 - 0.051 min, vs. 0.023 min, IQR 0.015 - 0.025 min, P = 0.002; TBR 1.84, 1.64 - 2.50, vs. 1.26, IQR 0.91 - 1.36, P = 0.001; LV myocardial SUV 3.84, IQR 1.87 - 5.65, vs. 1.35, IQR 1.17 - 2.28, P = 0.029; ratio of LV myocardial to liver SUV 0.67, IQR 0.44 - 1.64, vs. 0.18, IQR 0.15 - 0.35, P = 0.004). The myocardial RI, TBR and myocardial to liver SUV ratio also distinguished the control subjects from subjects with transthyretin and those with light chain amyloid. Conclusion: F-Florbetapir PET may be a promising technique to image light chain and transthyretin cardiac amyloidosis. Its role in diagnosing amyloid in other organ systems and in assessing response to therapy needs to be further studied.


Related Articles

  • Cardiac amyloidosis evaluation by bedside ultrasound in the emergency department. A case report. Lavine, Elyse; Siadecki, Sebastian D.; Lewiss, Resa E.; Frasure, Sarah E.; Saul, Turandot // Medical Ultrasonography;Mar2014, Vol. 16 Issue 1, p63 

    Cardiac amyloidosis is a disease process of abnormal amyloid fibril deposition in cardiac muscle that can be diagnosed by specific electrocardiographic and echocardiographic findings. We present the case of a patient with a history of cardiac amyloidosis who presented to the emergency department...

  • Skin Involvement in Generalized Amyloidosis. Rubinow, Alan; Cohen, Alan S. // Annals of Internal Medicine;Jun78, Vol. 88 Issue 6, p781 

    Provides information on a study which examined clinically involved and uninvolved skin in 50 patients with primary and secondary amyloidosis. Description of primary and multiple myeloma-associated amyloidosis; Extent of amyloid involvement in skin biopsies in primary and multiple...

  • Malnutrition, pharmaconutrition and other considerations in AL amiloidosis, a rare disease with masquerading symptoms and usually delayed diagnosis. Franco-López, Ángeles; Culebras, Jesús M. // Nutricion Hospitalaria;jun2015, Vol. 31 Issue 6, p2337 

    Amyloid Light-chain (AL) amyloidosis is a very rare disease. Nutritional and pharmaconutrional aspects are described. Nutrition repletion of malnourished AL patients is an essential strategy for improving treatment efficacy and clinical outcomes. Early diagnosis of AL amiloidosis is difficult to...

  • Small Transthyretin (TTR) Ligands as Possible Therapeutic Agents in TTR Amyloidoses. Almeida, M. R.; Gales, L.; Damas, A. M.; Cardoso, I.; Saraiva, M. J. // Current Drug Targets - CNS & Neurological Disorders;Oct2005, Vol. 4 Issue 5, p587 

    In transthyretin (TTR) amyloidosis TTR variants deposit as amyloid fibrils giving origin, in most cases, to peripheral polyneuropathy, cardiomyopathy, carpal tunnel syndrome and/or amyloid deposition in the eye. More than eighty TTR variants are known, most of them being pathogenic. The...

  • Amyloid Mimics Chronic Inflammatory Demyelinating Polyneuropathy. Rubin, Michael // Neurology Alert;Oct2011, Vol. 30 Issue 2, p10 

    Amyloidosis may present with the clinical and electrophysiologic features of chronic inflammatory demyelinating polyneuropathy. Nerve biopsy may be necessary to make an accurate diagnosis.

  • Amyloidosis Complicating Rhinophyma Amyloidosis Complicating Rhinophyma. Nanda, V.; Garg, B.K.; Chittoria, R.; Biswas, G.; Sharma, R.K. // Aesthetic Plastic Surgery;Mar/Apr2004, Vol. 28 Issue 2, p98 

    Rhinophyma is the advanced stage of acne rosacea and a source of embarrassment for the patient. Secondary localized cutaneous amyloidosis complicating rhinophyma is not reported in the literature. A patient with rhinophyma was treated by excision and primary closure. The histologic examination...

  • Transmission of Mouse Senile Amyloidosis. Xing, Yanming; Nakamura, Akihiro; Chiba, Takuya; Kogishi, Kumiko; Matsushita, Takatoshi; Li, Fu; Guo, Zhanjun; Hosokawa, Masanori; Mori, Masayuki; Higuchi, Keiichi // Laboratory Investigation (00236837);Apr2001, Vol. 81 Issue 4, p493 

    In mouse senile amyloidosis, apolipoprotein A-II polymerizes into amyloid fibrils (AApoAII) and deposits systemically. Peripheral injection of AApoAII fibrils into young mice induces systemic amyloidosis (Higuchi et al, 1998). We isolated AApoAII amyloid fibrils from the livers of old...

  • Nasal and ocular amyloidosis in a 15-year-old horse. Østevik, Liv; Gunnes, Gjermund; de Souza, Gustavo A.; Wien, Tale N.; Sørby, Randi // Acta Veterinaria Scandinavica;2014, Vol. 56 Issue 1, p1 

    Localized nasal, conjunctival and corneal amyloidosis was diagnosed in a 15-year-old pony with nasal and conjunctival masses and severe dyspnoea. Multiple swellings had been evident in the nostrils for at least two years and had gradually increased in size before presentation due to dyspnoea and...

  • Progress on Cutaneous Amyloidoses. Hashimoto, Ken // Journal of Investigative Dermatology;Jan1984, Vol. 82 Issue 1, p1 

    Investigation of amyloidoses began with identification and classification of Congo red-positive deposition in the early 1920s. Investigation of cutaneous forms in the field progressed with the use of new methodologies such as metachromatic staining with crystal violet, thioflavin T fluorescence,...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics