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Journal of Nuclear Cardiology

Erschienen in:

01.10.2018 | Original Article

¹⁸Fluorine sodium fluoride positron emission tomography, a potential biomarker of transthyretin cardiac amyloidosis

verfasst von: Rachelle Morgenstern, MPH, Randy Yeh, MD, Adam Castano, MD, MS, Mathew S. Maurer, MD, Sabahat Bokhari, MD

Erschienen in: Journal of Nuclear Cardiology | Ausgabe 5/2018

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Abstract

Background

Non-invasive imaging to diagnose and quantify amyloid load, progression, and response to treatment are central for the care of patients with cardiac amyloidosis. ¹⁸Fluorine-labeled sodium fluoride (¹⁸F-NaF) is a widely available radioisotope and PET imaging allows for absolute quantification of tracer uptake.

Methods

Patients with biopsy-proven transthyretin (ATTR-CA) and light-chain cardiac amyloidosis (AL) (3 ATTRwt, 2 ATTRV122I, 2 AL) and controls (n = 5), underwent ¹⁸F-NaF PET imaging. Scans were assessed visually for radiotracer uptake and analyzed using standard uptake values in the entire myocardium (SUVm) and in a 17-segment cardiac model. Wilcoxon rank-sum tests were used for statistical analyses.

Results

Qualitative ¹⁸F-NaF uptake was absent in controls and AL patients. There was qualitative ¹⁸F-NaF uptake in ATTR-CA patients, with slightly increased uptake in wild-type patients. SUVm for controls and AL patients overlapped at 0.8(0.4-0.9) and 0.95(0.9-1.0), respectively (P = 0.434). At 1.5(1.4-1.7), SUVm for ATTR-CA patients was ≈1.5*SUVm of controls (P = 0.012) and AL patients (P = 0.078). While there was diffuse ¹⁸F-NaF myocardial in ATTR-CA patients, the degree of uptake varied according to cardiac segment.

Conclusion

¹⁸F-NaF PET effectively imaged and differentiated ATTR-CA patients. Semi-automatic software enabled quantification of radiotracer uptake and regional distribution. ¹⁸F-NaF PET may be useful for disease monitoring and localizing amyloid deposition in ATTR-CA patients.

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Titel: 18Fluorine sodium fluoride positron emission tomography, a potential biomarker of transthyretin cardiac amyloidosis
verfasst von: Rachelle Morgenstern, MPH
Randy Yeh, MD
Adam Castano, MD, MS
Mathew S. Maurer, MD
Sabahat Bokhari, MD
Publikationsdatum: 01.10.2018
Verlag: Springer US
Erschienen in: Journal of Nuclear Cardiology / Ausgabe 5/2018
Print ISSN: 1071-3581
Elektronische ISSN: 1532-6551
DOI: https://doi.org/10.1007/s12350-017-0799-x

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¹⁸Fluorine sodium fluoride positron emission tomography, a potential biomarker of transthyretin cardiac amyloidosis