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European Journal of Nuclear Medicine and Molecular Imaging

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01-07-2019 | Echocardiography | Original Article

Detection of cardiac amyloidosis with ¹⁸F-Florbetaben-PET/CT in comparison to echocardiography, cardiac MRI and DPD-scintigraphy

Authors: Malte Kircher, Sandra Ihne, Joachim Brumberg, Caroline Morbach, Stefan Knop, K. Martin Kortüm, Stefan Störk, Andreas K. Buck, Theresa Reiter, Wolfgang R. Bauer, Constantin Lapa

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 7/2019

Abstract

Purpose

Cardiac amyloidosis (CA) is a rare cause of heart failure with frequently delayed diagnosis, because specific early signs or symptoms are missing. Recently, direct amyloid imaging using positron emission tomography/computed tomography (PET/CT) has emerged.

The aim of this study was to examine the performance of ¹⁸F-florbetaben-PET/CT in detection of CA, and compare it to echocardiography (echo), cardiac MRI (CMR) and scintigraphy. Additionally, the use of ¹⁸F-florbetaben-PET/CT for quantification of amyloid burden and monitoring of treatment response was assessed.

Methods

Twenty-two patients with proven (n = 5) or clinical suspicion (n = 17) of CA underwent ¹⁸F-florbetaben-PET/CT for diagnostic work-up. Qualitative and quantitative assessment including calculation of myocardial tracer retention (MTR) was performed, and compared to echo (n = 20), CMR (n = 16), scintigraphy (n = 16) and serologic biomarkers (NT-proBNP, cTnT, free light chains). In four patients, follow-up PET/CT was available (after treatment initiation, n = 3; surveillance, n = 1).

Results

PET demonstrated myocardial ¹⁸F-florbetaben retention consistent with CA in 14/22 patients. Suspicion of CA was subsequently dropped in all eight PET-negative patients. Amyloid subtypes showed characteristic retention patterns (AL > AA > ATTR; all p < 0.005). MTR correlated with morphologic and functional parameters, as measured by CMR and echo (all r| > 0.47|, all p < 0.05), but not with cardiac biomarkers. Changes in MTR from baseline to follow-up corresponded well to treatment response, as assessed by cardiac biomarkers and performance status.

Conclusions

Imaging of cardiac amyloidosis (CA) with ¹⁸F-florbetaben-PET/CT is feasible and might be useful in differentiating CA subtypes.

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Title: Detection of cardiac amyloidosis with 18F-Florbetaben-PET/CT in comparison to echocardiography, cardiac MRI and DPD-scintigraphy
Authors: Malte Kircher
Sandra Ihne
Joachim Brumberg
Caroline Morbach
Stefan Knop
K. Martin Kortüm
Stefan Störk
Andreas K. Buck
Theresa Reiter
Wolfgang R. Bauer
Constantin Lapa
Publication date: 01-07-2019
Publisher: Springer Berlin Heidelberg
Keywords: Echocardiography
Cardiac Amyloidosis
Echocardiography
Cardiac MRI
Positron Emission Tomography
Scintigraphy
Amyloidosis
AL Amyloidosis
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 7/2019
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-019-04290-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Detection of cardiac amyloidosis with ¹⁸F-Florbetaben-PET/CT in comparison to echocardiography, cardiac MRI and DPD-scintigraphy

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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