Erschienen in:
13.06.2023 | ORIGINAL ARTICLE
Prevalence and significance of extracardiac uptake on pyrophosphate imaging in the SCAN-MP study: the first 379 cases
verfasst von:
Nicholas Chan, MD, MS, Andrew J. Einstein, MD, PhD, MASNC, Jan M. Griffin, MD, Hannah Rosenblum, MD, MS, Sergio Teruya, MD, MS, Margaret Cuomo, MSN, FNP-C, Jeffeny De Los Santos, MD, Albert DeLuca, MD, Lynne L. Johnson, MD, Mona P. Kinkhabwala, MD, Jay S. Leb, MD, Akiva Mintz, MD, PhD, Denise Fine, MS, Stephen Helmke, RDCS, MPH, Varsha Muralidhar, MD, Shivda Pandey, MD, Natalia Sabogal, BS, Sunil E. Saith, MD, MPH, Morgan Winburn, RDCS, MS, Dia Smiley, DO, Edward J. Miller, MD, PhD, Frederick L. Ruberg, MD, Mathew S. Maurer, MD
Erschienen in:
Journal of Nuclear Cardiology
|
Ausgabe 6/2023
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Abstract
Introduction
Technetium-labeled bone-avid radiotracers can be used to diagnose transthyretin cardiac amyloidosis (ATTR-CA). Extracardiac uptake of technetium pyrophosphate (Tc-99m PYP) in this context has not been extensively explored and its significance is not well characterized. We assessed extracardiac Tc-99m PYP uptake in individuals undergoing nuclear scintigraphy and the extent of clinically actionable findings.
Methods
The Screening for Cardiac Amyloidosis with Nuclear Imaging in Minority Populations (SCAN-MP) study utilizes Tc-99m PYP imaging to identify ATTR-CA in self-identified Black and Caribbean Hispanic participants ≥ 60 years old with heart failure. We characterized the distribution of extracardiac uptake, including stratification of findings by timing of scan (1 hour vs 3 hours after Tc-99m PYP administration) and noted any additional testing in these subjects.
Results
Of 379 participants, 195 (51%) were male, 306 (81%) Black race, and 120 (32%) Hispanic ethnicity; mean age was 73 years. Extracardiac Tc-99m PYP uptake was found in 42 subjects (11.1%): 21 with renal uptake only, 14 with bone uptake only, 4 with both renal and bone uptake, 2 with breast uptake, and 1 with thyroid uptake. Extracardiac uptake was more common in subjects with Tc-99m PYP scans at 1 hour (23.8%) than at 3 hours (6.2%). Overall, four individuals (1.1%) had clinically actionable findings.
Conclusion
Extracardiac Tc-99m PYP uptake manifested in about 1 in 9 SCAN-MP subjects but was clinically actionable in only 1.1% of cases.