Extracardiac soft tissue uptake, evidenced on early 99mTc-HMDP SPECT/CT, helps typing cardiac amyloidosis and demonstrates high prognostic value

Autor:	Arnault Galat, Anissa Moktefi, Thibaud Damy, Benoît Funalot, Silvia Oghina, Pascale Fanen, Emmanuel Itti, Paul Blanc-Durand, Jean-François Deux, Soulef Guendouz, Valérie Molinier-Frenkel, Mukedaisi Abulizi, Nathan Malka, Vincent Audard, Diane Bodez, Mounira Kharoubi, Jean-Pascal Lefaucheur, Fabien Le Bras
Rok vydání:	2020
Předmět:	medicine.medical_specialty biology medicine.diagnostic_test business.industry Amyloidosis Soft tissue General Medicine medicine.disease Scintigraphy Gastroenterology 030218 nuclear medicine & medical imaging Clinical Practice 03 medical and health sciences Transthyretin 0302 clinical medicine Cardiac amyloidosis 030220 oncology & carcinogenesis Internal medicine medicine biology.protein Radiology Nuclear Medicine and imaging Digestive tract Typing business
Zdroj:	European Journal of Nuclear Medicine and Molecular Imaging. 47:2396-2406
ISSN:	1619-7089 1619-7070
Popis:	Increased cardiac uptake (CU) on early-phase 99mTc-HMDP scintigraphy has demonstrated diagnostic and prognostic values in amyloid transthyretin (ATTR) cardiac amyloidosis (CA). Extracardiac uptake (ECU) has been poorly studied. We assessed the clinical value of ECU, in combination with CU, on 99mTc-HMDP scintigraphy using a novel Methodological Amyloidosis Diagnostic Index (MADI). We reviewed all patients referred for suspicion of CA, who underwent 99mTc-HMDP scintigraphy over an 8-year period. ECU, CU, and MADI were determined: MADI0 = neither ECU or CU, MADI1 = ECU alone, MADI2 = CU alone, and MADI3 = ECU + CU. Of 308 eligible patients, 247 had CA, including 75 ATTRv, 107 ATTRwt, and 65 light-chain (AL), while 61 had another cardiopathy (controls). ECU was observed in 29% of CA and 3% of controls. Most frequent sites of ECU were pleuropulmonary (16% of CA, 3% of controls) followed by the digestive tract and subcutaneous tissues. The liver and spleen ECU was only observed in AL-CA (n = 8). CU was only observed in CA patients (n = 187), of whom 182 had ATTR-CA vs. 5 AL-CA, P 0 vs. MADI0 in AL and MADI3 vs. MADI2 in ATTR were associated with a worse prognosis (P = 0.03 and P = 0.002, respectively). ECU combined with CU demonstrates high diagnostic and prognostic values in CA patients. MADI seems an easy and reliable score in clinical practice.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::085afdb16e015c8ce0a5337089704469 https://doi.org/10.1007/s00259-020-04753-7 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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