Utility of Technetium Tc 99m Pyrophosphate Bone Scanning in Cardiac Amyloidosis

Morie A. Gertz, Manuel L. Brown, Mary F. Hauser, Robert A. Kyle

Research output: Contribution to journalArticlepeer-review

48 Scopus citations


Thirty-four patients with amyloidosis proved by biopsy specimen were studied using technetium Tc 99m pyrophosphate scintigraphy to assess its utility in the diagnosis of amyloid heart involvement. Of 14 patients studied retrospectively, only three had intense uptake judged to be diagnostic of cardiac amyloidosis. In a prospective analysis of 20 patients with amyloidosis, all of whom had evidence of cardiac involvement by two-dimensional echocardiography, 17 had abnormal scans. Fourteen of the 17 scans had only 1+ or 2+ uptake, a finding that also was present in 15 of the 20 control patients (without amyloid heart disease). Only three of the 20 patients with cardiac amyloidosis had intense uptake that was considered unequivocal and diagnostic of amyloidosis. Of the five patients with biopsy specimen proof of endomyocardial amyloidosis, only one had intense uptake and one had no uptake. When intense uptake of technetium Tc 99m pyrophosphate is found in the heart of a patient, amyloidosis is highly likely. The technique, however, is not sufficiently sensitive to warrant routine screening of patients with amyloidosis or cardiomyopathies. Cross-sectional echocardiography is superior to pyrophosphate scintigraphy for recognition of cardiac amyloidosis.

Original languageEnglish (US)
Pages (from-to)1039-1044
Number of pages6
JournalArchives of internal medicine
Issue number6
StatePublished - Jun 1987

ASJC Scopus subject areas

  • Internal Medicine


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