TY - JOUR
T1 - Emerging Role of Scintigraphy Using Bone-Seeking Tracers for Diagnosis of Cardiac Amyloidosis
T2 - AJR Expert Panel Narrative Review
AU - Slart, Riemer H.J.A.
AU - Chen, Wengen
AU - Tubben, Alwin
AU - Tingen, Hendrea S.A.
AU - Davies, Daniel R.
AU - Grogan, Martha
AU - Wechalekar, Ashutosh D.
AU - Kittleson, Michelle M.
AU - Thomson, Louise E.J.
AU - Slomka, Piotr J.
AU - Wechalekar, Kshama
AU - Chareonthaitawee, Panithaya
N1 - Publisher Copyright:
© American Roentgen Ray Society.
PY - 2024/1
Y1 - 2024/1
N2 - Amyloidoses are a complex group of clinical diseases that result from progressive organ dysfunction due to extracellular protein misfolding and deposition. The two most common types of cardiac amyloidosis are transthyretin amyloidosis (ATTR) and light-chain (AL) amyloidosis. Diagnosis of ATTR cardiomyopathy (ATTR-CM) is challenging owing to its phenotypic similarity to other more common cardiac conditions, the perceived rarity of the disease, and unfamiliarity with its diagnostic algorithms; endomyocardial biopsy was historically required for diagnosis. However, myocardial scintigraphy using bone-seeking tracers has shown high accuracy for detection of ATTR-CM and has become a key noninvasive diagnostic test for the condition, receiving support from professional society guidelines and transforming pri- or diagnostic paradigms. This AJR Expert Panel Narrative Review describes the role of myocardial scintigraphy using bone-seeking tracers in the diagnosis of ATTR-CM. The article summarizes available tracers, acquisition techniques, interpretation and reporting considerations, diagnostic pitfalls, and gaps in the current literature. The critical need for monoclonal testing of patients with positive scintigraphy results to differentiate ATTR-CM from AL cardiac amyloidosis is highlighted. Recent updates in guideline recommendations that emphasize the importance of a qualitative visual assessment are also discussed.
AB - Amyloidoses are a complex group of clinical diseases that result from progressive organ dysfunction due to extracellular protein misfolding and deposition. The two most common types of cardiac amyloidosis are transthyretin amyloidosis (ATTR) and light-chain (AL) amyloidosis. Diagnosis of ATTR cardiomyopathy (ATTR-CM) is challenging owing to its phenotypic similarity to other more common cardiac conditions, the perceived rarity of the disease, and unfamiliarity with its diagnostic algorithms; endomyocardial biopsy was historically required for diagnosis. However, myocardial scintigraphy using bone-seeking tracers has shown high accuracy for detection of ATTR-CM and has become a key noninvasive diagnostic test for the condition, receiving support from professional society guidelines and transforming pri- or diagnostic paradigms. This AJR Expert Panel Narrative Review describes the role of myocardial scintigraphy using bone-seeking tracers in the diagnosis of ATTR-CM. The article summarizes available tracers, acquisition techniques, interpretation and reporting considerations, diagnostic pitfalls, and gaps in the current literature. The critical need for monoclonal testing of patients with positive scintigraphy results to differentiate ATTR-CM from AL cardiac amyloidosis is highlighted. Recent updates in guideline recommendations that emphasize the importance of a qualitative visual assessment are also discussed.
KW - SPECT
KW - bone scintigraphy
KW - cardiac amyloidosis
KW - clinical scenarios
KW - imaging perspectives
KW - pitfalls
KW - procedurals
UR - http://www.scopus.com/inward/record.url?scp=85170208271&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85170208271&partnerID=8YFLogxK
U2 - 10.2214/AJR.23.29347
DO - 10.2214/AJR.23.29347
M3 - Review article
C2 - 37315017
AN - SCOPUS:85170208271
SN - 0361-803X
VL - 222
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
IS - 1
M1 - e2329347
ER -