18F-Florbetaben PET/CT for the Diagnosis and Subtyping of Cardiac Amyloidosis: A Case Series and Review of the Literature.
Journal
Acta Cardiologica Sinica
Journal Volume
40
Journal Issue
5
Start Page
635
End Page
643
ISSN
1011-6842
Date Issued
2024-09
Author(s)
Shih, Yu-Cheng
Tzeng, Bing-Hsiean
Tsai, Meng-Chieh
Yu, Yuan-Bin
Shiau, Yu-Chien
Wang, Shan-Ying
Abstract
Objectives: Cardiac amyloidosis (CA) is a type of systemic amyloidosis. Amyloid-targeting positron emission tomography (PET) has shown potential as an imaging method for CA. However, the optimal imaging protocol and role of18 F-florbetaben (FBB) PET in the diagnosis and subtyping of CA have yet to be determined. Methods: Patients with suspected CA who had positive or equivocal results of technetium-99m pyrophosphate (PYP) scintigraphy were enrolled for dynamic and late FBB PET imaging. In addition to visual assessment, a kinetic modeling-based approach including target-to-background ratio (TBR) and myocardial retention fraction (RF) of serial images reconstructed from a 20-min dynamic acquisition, and a late image at 110 min post-injection were performed. We compared FBB PET measures of four typical patients with light chain amyloidosis (AL), wild-type transthyretin amyloidosis (ATTRwt), variant transthyretin amyloidosis (ATTRv), and heart failure, respectively. We also reviewed the literature on the clinical use of amyloid PET in CA. Results: Myocardial tracer retention was only found in the AL patient on the late images. TBR and RF were highest in the AL patient followed by the ATTRwt patient, and lowest in the ATTRv and non-CA patients. Conclusions: FBB PET has potential in the detection and non-invasive subtyping of CA, especially in subjects with equivocal PYP findings or monoclonal gammopathy. © 2024, Republic of China Society of Cardiology. All rights reserved.
Subjects
18F-florbetaben (FBB)
Heart failure
Light-chain cardiac amyloidosis (AL-CA)
Positron emission tomography (PET)
Transthyretin cardiac amyloidosis (ATTR-CA)
Publisher
Republic of China Society of Cardiology
Type
journal article