Laryngeal and cardiac amyloidosis diagnosed by 18F-Florbetapir PET/CT

García-González, Pilar; Sánchez-Jurado, Raúl; Cózar-Santiago, M.P.; Ferrando-Beltrán, Mónica; Pérez-Rodríguez, Pedro; Ferrer-Rebolleda, J.

doi:10.1016/j.remn.2016.03.006

Cited by 3 publications

(3 citation statements)

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“…The other limitation is that 123 I-SAP scintigraphy images the liver, spleen, kidneys and bone, but cannot image the hollow viscera, other soft tissues and heart. Recently, extracardiac uptake of PET tracers ( 18 F-florbetapir, 18 F-florbetaben and 11 C-PIB) has been described in a few case reports: in the larynx [ 21 ], cerebral amyloidoma [ 22 ], in the kidneys in ALECT2 type of amyloidosis [ 23 ] and in the brain [ 24 ]. The only systematic study of extracardiac uptake has recently been published [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Extracardiac 18F-florbetapir imaging in patients with systemic amyloidosis: more than hearts and minds

Wagner

Page

Burniston

et al. 2018

Eur J Nucl Med Mol Imaging

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Purpose18F-Florbetapir has been reported to show cardiac uptake in patients with systemic light-chain amyloidosis (AL). This study systematically assessed uptake of 18F-florbetapir in patients with proven systemic amyloidosis at sites outside the heart.MethodsSeventeen patients with proven cardiac amyloidosis underwent 18F-florbetapir PET/CT imaging, 15 with AL and 2 with transthyretin amyloidosis (ATTR). Three patients had repeat scans. All patients had protocolized assessment at the UK National Amyloidosis Centre including imaging with 123I-serum amyloid P component (SAP). 18F-Florbetapir images were assessed for areas of increased tracer accumulation and time–uptake curves in terms of standardized uptake values (SUVmean) were produced.ResultsAll 17 patients showed 18F-florbetapir uptake at one or more extracardiac sites. Uptake was seen in the spleen in 6 patients (35%; 6 of 9, 67%, with splenic involvement on 123I-SAP scintigraphy), in the fat in 11 (65%), in the tongue in 8 (47%), in the parotids in 8 (47%), in the masticatory muscles in 7 (41%), in the lungs in 3 (18%), and in the kidney in 2 (12%) on the late half-body images. The 18F-florbetapir spleen retention index (SRI) was calculated. SRI >0.045 had 100% sensitivity/sensitivity (in relation to 123I-SAP splenic uptake, the current standard) in detecting splenic amyloid on dynamic imaging and a sensitivity of 66.7% and a specificity of 100% on the late half-body images. Intense lung uptake was seen in three patients, one of whom had lung interstitial infiltration suggestive of amyloid deposition on previous high-resolution CT. Repeat imaging showed a stable appearance in all three patients suggesting no early impact of treatment response.Conclusion18F-Florbetapir PET/CT is a promising tool for the detection of extracardiac sites of amyloid deposition. The combination of uptake in the heart and uptake in the spleen on 18F-florbetapir PET/CT, a hallmark of AL, suggests that this tracer holds promise as a screening tool for AL.Electronic supplementary materialThe online version of this article (10.1007/s00259-018-3995-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Extracardiac 18F-florbetapir imaging in patients with systemic amyloidosis: more than hearts and minds

Wagner

Page

Burniston

et al. 2018

Eur J Nucl Med Mol Imaging

View full text Add to dashboard Cite

show abstract

“…To date, multiple radiotracers have been shown to specifically bind to the amyloid plaques and visualize their changes in real-time. Promising results have also been demonstrated in detecting cardiac amyloid deposition by semi-quantitative 18 F-Florbetapir PET/CT [ [6] , [7] , [8] ]. Despite various excellent targeted imaging techniques in conjunction with different radiotracers that have been implemented, CA remains underdiagnosed at present.…”

Section: Introductionmentioning

confidence: 99%

“…Semi-quantitative measurement using standardized uptake value (SUV) was predominantly used in estimating the uptake of the radiotracer in the body. Previous CA studies by 18 F-Florbetapir PET have demonstrated SUV method is a promising technique in the assessment of cardiac amyloid [ [6] , [7] , [8] ]. It is noteworthy that SUVs reflect the total activity that comprises not only the specific bio-pathophysiological information of interest but also free and non-specific signals.…”

Section: Introductionmentioning

confidence: 99%