Visualization of multiple organ amyloid involvement in systemic amyloidosis using 11C-PiB PET imaging

Abstract

C-PiB PET imaging can be used clinically in the systemic evaluation of amyloid distribution in patients with AL and ATTRm amyloidosis. Quantitative analysis of C-PiB PET images may be useful in therapy evaluation and will reveal whether amyloid clearance is correlated with clinical response.

From Stroke to Dementia: a Comprehensive Review Exposing Tight Interactions Between Stroke and Amyloid-β Formation

“…In humans, most of the CSF drains into the blood via arachnoid villi and granulations in the major venous sinus [70]. In recent years, studies have found that CSF can drain solutes, such as Aβ, out of the brain through the glymphatic system, along cranial nerves and possible lymphatic vessels in the dura [71][72][73][74]. In line with these findings, single-photon emission computed tomography combined with a systemic injection of radiolabeled Pittsburg Compound B (PiB) in rodents demonstrated that Aβ is drained out of the brain through the ISF/CSF in the nasal mucosa [75].…”

Early Detection of Multiorgan Light-Chain Amyloidosis by Whole-Body 18F-Florbetapir PET/CT

“…In several organ systems, including kidney (13% vs. 28%) and abdominal wall fat (10% vs. 13%), PET identified involvement in fewer subjects than did international consensus. Quantitative analysis of 18 F-florbetapir PET/CT revealed more frequent organ involvement than did visual analysis in the tongue, thyroid, lung, pancreas, kidney, muscle, and humeral head. Extensive organ amyloid deposits were observed in active AL as well as in AL remission cohorts, and in both cardiac and noncardiac AL cohorts.…”

“…An SUV max of at least 2.5 was considered abnormal in all organs other than the liver. Results: Compared with the international consensus definition of organ involvement, 18 F-florbetapir PET/CT identified amyloid deposits in substantially higher percentages of subjects for several organ systems, including parotid gland (50% vs. 3%), tongue (53% vs. 10%), and lung (35% vs. 10%). In several organ systems, including kidney (13% vs. 28%) and abdominal wall fat (10% vs. 13%), PET identified involvement in fewer subjects than did international consensus.…”

“…Targeted amyloid imaging with 18 F-florbetapir PET/CT offers the potential to detect AL deposits in multiple organs. The primary aim of this study was to determine the distribution and frequency of AL deposits in the various organs of subjects with systemic AL amyloidosis using 18 F-florbetapir PET/ CT. Methods: This prospective study included 40 subjects with biopsy-proven AL amyloidosis including active AL amyloidosis (n 5 30) or AL amyloidosis in hematologic remission for more than 1 y (n 5 10). All subjects underwent 18 F-florbetapir PET/CT, skull base to below the kidney scan field, from 60 to 90 min after injection of radiotracer.…”

“…The primary aim of this study was to determine the distribution and frequency of AL deposits in the various organs of subjects with systemic AL amyloidosis using 18 F-florbetapir PET/ CT. Methods: This prospective study included 40 subjects with biopsy-proven AL amyloidosis including active AL amyloidosis (n 5 30) or AL amyloidosis in hematologic remission for more than 1 y (n 5 10). All subjects underwent 18 F-florbetapir PET/CT, skull base to below the kidney scan field, from 60 to 90 min after injection of radiotracer. Volume-of-interest measurements of SUV max were obtained using Hermes software for the parotid gland, tongue, thyroid, lung, gastric wall, pancreas, spleen, kidney, muscle, abdominal fat, lower thoracic spine, vertebral body, and humeral head.…”