11C-Pittsburgh B PET Imaging in Cardiac Amyloidosis

Abstract

(11)C-PiB PET/CT may be valuable for the diagnosis of cardiac amyloidosis noninvasively. Whether (11)C-PiB PET/CT may be a good surrogate marker of active light chain deposition in the myocardium warrants further investigation in a larger number of patients.

18 F-Florbetapir Binds Specifically to Myocardial Light Chain and Transthyretin Amyloid Deposits

“…18 F-florbetapir 5 (and 11 C-PiB) 4, 8 have been used to successfully image AL and ATTR cardiac amyloidosis in pilot human studies. Our study confirms high specific binding of 18 F-florbetapir in myocardial AL and ATTR amyloid deposits.…”

Role of imaging in cardiac amyloidosis: An ongoing challenge

“…11 C-labeled Pittsburgh compound B ( 11 C-PiB) 17,18 and 18 F-florbetapir (Amyvid, Eli Lilly) 19 have also been reported to be useful in cardiac amyloid imaging in a couple of small studies. 18 F-florbetapir appears to be sensitive in both AL and ATTR amyloidosis but further studies are needed.…”

“…Monitoring change in amyloid deposits (by imaging) is currently undertaken using echocardiography for cardiac amyloidosis and, where available, SAP scintigraphy for extra-cardiac amyloid deposits. The utility of other imaging modalities, like CMR, 99m TcDPD/PYP scintigraphy, or 18 F-florbetapir, to assess amyloid progression or regression on serial imaging remains unclear. Echocardiography has significant limitations in monitoring of cardiac amyloidosis due to marked interoperator variability and poor sensitivity/specificity for determining changes, particularly subtle changes, and over time.…”

“…The availability of novel imaging with equilibrium CMR, the bisphosphonate imaging agents, PET scanning with agents like 18 F-Florbetapir, and advanced techniques in echocardiography is bringing imaging for cardiac amyloidosis into the main stream. Innovative trials integrating anti-amyloid therapies with novel imaging to assess their utility has a promise to change the outcomes in this progressive and fatal disease.…”

Setting the stage for the next step in cardiac amyloidosis imaging: Serial quantitative studies to assess disease activity

“…19 Prior efforts at PET imaging in cardiac amyloidosis used F-18 Florbetapir and C-11 Pittsburgh Compound B (PiB). 20,21 Quantitative SUV measurements were used to optimize diagnostic sensitivity. However, PET approaches have yet not been studied for the assessment of serial changes in amyloid burden.…”