The evolving landscape of nuclear imaging in cardiac amyloidosis

Review of cardiovascular imaging in the Journal of Nuclear Cardiology 2020: positron emission tomography, computed tomography, and magnetic resonance

“… 37 Not only is 11C-PIB useful in the diagnosis of CA, but also recently shown to have prognostic value as shown in small size pilot study comparing 11C-PIB PET/CT with 99mTc-aprotinin scintigraphy in subjects with CA with serial imaging over a period of 2 months. 38 Despite the small size sample and potential false-positive results from Tc-aprotinin, the results are “certainly provocative and represent early efforts to identify PET imaging techniques that offer prognostic data in patients with CA and thus the ability to potentially guide management decisions.” 39 While the clinical use of 11C-PIB might be challenging given its short half-life and the need for an on-site cyclotron, 18F-florbetapir (FDA-approved brain imaging agent) is an emerging PET tracer which may circumvent some of these limitations and potentially prove to be useful in the evolving landscape of nuclear imaging in CA.…”

Transforming ATTR cardiac amyloidosis into a chronic disease: The enormous potential of quantitative SPECT to improve diagnosis, prognosis, and monitoring of disease progression

“…Moreover, early studies demonstrate PET tracers may have the ability to prognosticate as well as diagnose. [21][22][23] The primary limitations of PET are that it is less readily available in non-academic sites, requires expensive imaging hardware, and has more challenging tracer acquisition, often requiring on-site cyclotrons. Increased cost and radiation dose relative to SPECT are also reasonable concerns, especially as diagnostic workups for amyloidosis continue to increase worldwide.…”