Sensitivity of technetium-99m-pyrophosphate scintigraphy in diagnosing cardiac amyloidosis

Falk, Rodney H.; Lee, Victor W.; Rubinow, Alan; Hood, William B.; Cohen, Alan S.

doi:10.1016/s0002-9149(83)80140-4

Cited by 127 publications

(40 citation statements)

References 22 publications

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“…The sensitivity was higher than in previous reports [3-5, [8][9]. This is because in our study group of 50 patients, there were many senile systemic amyloidosis whose PYP accumulation rate is considered to be high [1], and few cases of AA amyloidosis and AL amyloidosis.…”

Section: Discussioncontrasting

confidence: 61%

“…In planar images, the degree of 99m Tc-PYP accumulation in the myocardium (myocardial accumulation rate) is screened visually, and is judged as the PYP score with five phases of classification according to Falk et al [8][9]. However, evaluation based on the PYP score is difficult because 99m Tc-PYP accumulates at the ribs and calcified costal cartilage and is carried by the systemic circulation.…”

Section: Introductionmentioning

confidence: 99%

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Novel method for quantitative evaluation of cardiac amyloidosis using 201TlCl and 99mTc-PYP SPECT

et al. 2012

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Tc-PYP accumulation in the myocardium. Patients were divided into two groups with and without a diagnosis of cardiac amyloidosis, and we examined the PYP accumulation rates in both groups. In addition, we examined the PYP scores of the two groups by conventional qualitative evaluation. Results: The PYP scores of the cardiac amyloidosis group were significantly higher than those of the other group. The PYP accumulation rates of the cardiac amyloidosis group were significantly higher than those of the other group. There was a significant difference in the PYP accumulation rate and PYP score between the two groups. There was considered to be the threshold between two groups in the case of PYP accumulation rate. Conclusions: When the threshold of the PYP score was defined as 3+ and that of the PYP accumulation rate was defined as 41.5%, the sensitivity of the PYP score and PYP accumulation rate was 84.6%. However, the specificity of the PYP accumulation rate was higher than that of the PYP score.Quantitative evaluation by PYP accumulation rate of the degree of 99m Tc-PYP accumulation in the myocardium may be useful in the diagnosis of cardiac amyloidosis. Novel quantitative cardiac amyloidosis evaluation method

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Section: Discussioncontrasting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

Novel method for quantitative evaluation of cardiac amyloidosis using 201TlCl and 99mTc-PYP SPECT

et al. 2012

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“…Of interest, neither patient had a RV outflow gradient but their Mmodes showed ESC of the pulmonary valve, another nonspecific finding in CA. Even "granular sparkling" can occur with other infiltrative cardiomyopathies (Bhandari and Nanda, 1983), and was recently reported in a patient with Fabry's disease although the ECG showed left ventricular hypertrophy and strain (Cohen et al, 1983). In 1984, 2-D echo studies in our laboratory of 10 other patients with clinical diagnoses of congestive cardiomyopathy revealed isolated localized myocardial sparkling.…”

Section: Echocardiographic Differentiation From Other Cardiomyopathiesmentioning

confidence: 62%

Cardiac Amyloidosis: Combined Use of Two‐Dimensional Echocardiography and Electrocardiography in Noninvasive Screening Before Biopsy

Sivaram

Jugdutt

Amy

et al. 1985

Clinical Cardiology

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Cardiac amyloidosis (CA) presenting with intractable congestive heart failure, electrocardiographic (ECG) normal or low voltage, and conduction or rhythm disturbances, is rapidly fatal. During life, CA often mimics other cardiomyopathies so that definitive diagnosis depends on demonstration of amyloid on myocardial biopsy. On two‐dimensional echocardiography (2‐D echo), nonspecific features, such as increased ventricular wall thicknesses, predominant diastolic dysfunction, and diffuse myocardial “sparkling,” are consistently found in CA. The combined presence of these 2‐D echo features and normal or low voltage on ECG is highly suggestive of CA, allows differentiation from other cardiomyopathies, and might be useful in noninvasive screening before myocardial biopsy.

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“…But of the 9 remaining patients with biopsyproven AL amyloidosis but with a normal echocardiogram, only 2 showed uptake in the heart. None of 10 control patients had a positive myocardial uptake [53]. So 99m TC-PYP myocardial scanning seems to be a sensitive test for the diagnosis of cardiac amyloidosis in patients with congestive heart failure.…”

Section: Amyloid Deposits 99m Tc-aprotininmentioning

confidence: 86%

Nuclear imaging in cardiac amyloidosis

Glaudemans

Slart

Zeebregts

et al. 2009

Eur J Nucl Med Mol Imaging

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Amyloidosis is a disease characterized by depositions of amyloid in organs and tissues. It can be localized (in just one organ) or systemic. Cardiac amyloidosis is a debilitating disease and can lead to arrhythmias, deterioration of heart function and even sudden death. We reviewed PubMed/Medline, without time constraints, on the different nuclear imaging modalities that are used to visualize myocardial amyloid involvement. Several SPECT tracers have been used for this purpose. The results with these tracers in the evaluation of myocardial amyloidosis and their mechanisms of action are described. Most clinical evidence was found for the use of 123 I-MIBG. Myocardial defects in MIBG activity seem to correlate well with impaired cardiac sympathetic nerve endings due to amyloid deposits. 123 I-MIBG is an attractive option for objective evaluation of cardiac sympathetic level and may play an important role in the indirect measurement of the effect of amyloid myocardial infiltration. Other, less sensitive, options are 99m Tc-aprotinin for imaging amyloid deposits and perhaps 99m Tc-labelled phosphate derivatives, especially in the differential diagnosis of the aetiology of cardiac amyloidosis. PET tracers, despite the advantage of absolute quantification and higher resolution, are not yet well evaluated for the study of cardiac amyloidosis. Because of these advantages, there is still the need for further research in this field.

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Sensitivity of technetium-99m-pyrophosphate scintigraphy in diagnosing cardiac amyloidosis

Cited by 127 publications

References 22 publications

Novel method for quantitative evaluation of cardiac amyloidosis using 201TlCl and 99mTc-PYP SPECT

Novel method for quantitative evaluation of cardiac amyloidosis using 201TlCl and 99mTc-PYP SPECT

Cardiac Amyloidosis: Combined Use of Two‐Dimensional Echocardiography and Electrocardiography in Noninvasive Screening Before Biopsy

Nuclear imaging in cardiac amyloidosis

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