Soft-tissue uptake of99m-Tc-diphosphonate and99mTc-pyrophosphate in amyloidosis

Janssen, Sven; Piers, Da; Vanrijswijk, Mh; Meijer, S; Mandema, E

doi:10.1007/bf00998166

Cited by 54 publications

(12 citation statements)

References 27 publications

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“…Various groups went on to investigate the utility of imaging cardiac amyloidosis with different bone-seeking radiotracers including technetium-3,3-diphosphono-1,2-propanodicarboxylic acid ( 99m Tc-DPD), 99m-technetium-methylene diphosphonate ( 99m Tc-MDP), and 99m Tc-PYP. The precise mechanism by which these bone-seeking radiotracers accumulate in the myocardium of patients with cardiac amyloidosis remains unclear but may be related to high calcium levels in amyloidosis 17, 18 . Moreover, the mechanism by which 99m Tc-PYP distinguishes ATTR from AL amyloidosis remains to be elucidated.…”

Section: Discussionmentioning

confidence: 99%

^99m Tc-Pyrophosphate Scintigraphy for Differentiating Light-Chain Cardiac Amyloidosis From the Transthyretin-Related Familial and Senile Cardiac Amyloidoses

Bokhari

Castaño

Pozniakoff

et al. 2013

Circ: Cardiovascular Imaging

546

303

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Background Differentiating immunoglobulin light-chain (AL) from transthyretin-related cardiac amyloidoses (ATTR) is imperative given implications for prognosis, therapy, and genetic counseling. We validated the discriminatory ability of 99mTc-pyrophosphate scintigraphy (99mTc-PYP) in AL vs. TTR-related cardiac amyloidoses. Methods and Results 45 subjects (12 AL, 16 ATTR wild-type, and 17 ATTR mutants) underwent 99mTc-PYP planar and single-photon positive emission computed tomography (SPECT) cardiac imaging. Scans were performed by experienced nuclear cardiologists blinded to the subjects’ cohort assignment. Cardiac retention was assessed with both a semi-quantitative visual score (range 0, no uptake to 3, diffuse uptake) and by quantitative analysis by drawing a region of interest (ROI) over the heart corrected for contralateral counts and calculating a heart-to-contralateral ratio (H/CL). Subjects with ATTR cardiac amyloid had a significantly higher semi-quantitative cardiac visual score than the AL cohort (2.9±0.06 vs. 0.8±0.27, p<0.0001) as well as a higher quantitative score (1.80±0.04 vs.1.21±0.04, p<0.0001). Using aH/CL ratio ≥ 1.5 consistent with intensely diffuse myocardial tracer retention had a 97% sensitivity and 100% specificity with area under the curve 0.992, p<0.0001 for identifying ATTR cardiac amyloidosis. Conclusion 99mTc-PYP cardiac imaging distinguishes AL from ATTR cardiac amyloidosis and may be a simple, widely available method for identifying subjects with ATTR cardiac amyloidosis which should be studied in a larger prospective manner.

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Section: Discussionmentioning

confidence: 99%

^99m Tc-Pyrophosphate Scintigraphy for Differentiating Light-Chain Cardiac Amyloidosis From the Transthyretin-Related Familial and Senile Cardiac Amyloidoses

Bokhari

Castaño

Pozniakoff

et al. 2013

Circ: Cardiovascular Imaging

546

303

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“…In their study, five out of eighteen patients with biopsy-proven amyloidosis had bone agent uptake in the liver. [11] In a case report by Kanoh, a patient of multiple myeloma had shown soft tissue localization of a bone-seeking agent, which that was attributable to the presence of amyloid deposits. [12]…”

Section: Discussionmentioning

confidence: 99%

Diffuse hepatic and splenic Tc-99m MDP tracer uptake in case of multiple myeloma

et al. 2010

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Tc-99m methylene diphosphonate (MDP) bone scintigraphy has long been used for the evaluation of benign as well as malignant skeletal conditions. However, non-osseous tracer uptake on a bone scan is an unusual finding. There is a need to understand the pathophysiological basis of the non-osseous uptake, which may have a clinical relevance or deteriorating effect on the quality of the bone scan. We describe a case of multiple myeloma, where extraosseous uptake in the form of diffuse hepatic and splenic uptake, with almost normal skeletal tracer distribution, has been seen on the bone scan.

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“…Different radiopharmaceuticals have been examined, including Ga-67 and Tc-99m sulfur colloid, with mixed results [17, 18]. Bone radionuclides have been shown to accumulate in different organs affected by amyloidosis, including the liver, skin, skeletal muscle, and myocardium [19, 20]. …”

Section: Discussionmentioning

confidence: 99%

Diffuse Hepatic and Spleen Uptake of Tc-99m MDP on Bone Scintigraphy Resembling Liver-Spleen Scintigraphy in a Patient of Plasma Cell Tumor

Ravanbod

Nemati

Javadi

et al. 2014

Case Reports in Radiology

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The present case demonstrates a diffuse intense hepatic and, to a lesser degree, spleen, Tc-99m MDP uptake on a routine bone scintigraphy resembling liver-spleen imaging. A 49-year-old female with a history of anaplastic plasma cell tumor and suffering from bone pain was referred for bone scintigraphy to evaluate possible bone metastases. The bone scintigraphy showed diffuse hepatic and spleen uptake of Tc-99m MDP resembling liver-spleen imaging. Furthermore, bone uptake of Tc-99m MDP was significantly diminished and there were no abnormal foci throughout the skeleton. The bone scintigraphy of the present case of an anaplastic plasma cell tumor suggests the possible presence of amyloidosis.

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Soft-tissue uptake of99m-Tc-diphosphonate and99mTc-pyrophosphate in amyloidosis

Cited by 54 publications

References 27 publications

^99m Tc-Pyrophosphate Scintigraphy for Differentiating Light-Chain Cardiac Amyloidosis From the Transthyretin-Related Familial and Senile Cardiac Amyloidoses

^99m Tc-Pyrophosphate Scintigraphy for Differentiating Light-Chain Cardiac Amyloidosis From the Transthyretin-Related Familial and Senile Cardiac Amyloidoses

Diffuse hepatic and splenic Tc-99m MDP tracer uptake in case of multiple myeloma

Diffuse Hepatic and Spleen Uptake of Tc-99m MDP on Bone Scintigraphy Resembling Liver-Spleen Scintigraphy in a Patient of Plasma Cell Tumor

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