Lung uptake during 99mTc-hydroxymethylene diphosphonate scintigraphy in patient with TTR cardiac amyloidosis: An underestimated phenomenon
| Autor: | Carlo Di Mario, Sofia Morini, Chiara Gallini, E. Costanzo, Francesca Tutino, Simone Bartolini, Raffaele Martone, Sabrina Frusconi, Luca Vaggelli, Federico Perfetto, Alfonso Ciaccio, Paola Angelotti, Francesco Cappelli |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty 030204 cardiovascular system & hematology Scintigraphy Left ventricular hypertrophy Gastroenterology 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Internal medicine AL amyloidosis medicine Humans Whole Body Imaging Radionuclide Imaging Lung Aged Retrospective Studies Aged 80 and over biology medicine.diagnostic_test business.industry Amyloidosis Technetium Middle Aged medicine.disease Transthyretin medicine.anatomical_structure Cardiac amyloidosis biology.protein Etiology Female Hypertrophy Left Ventricular 99mTc-HMDP Lung uptake TTR amyloidosis Cardiology and Cardiovascular Medicine Radiopharmaceuticals business |
| Zdroj: | International journal of cardiology. 254 |
| ISSN: | 1874-1754 |
| Popis: | Background Full body scintigraphy using bone tracers plays an important role in defining the type of amyloidosis and in diagnosing the heart involvement (cardiac amyloidosis, CA). No study has been conducted to explore lung retention (LR) in CA and its correlation to heart retention (HR).We evaluated LR in patients undergoing 99mTc-HMDP scintigraphy during evaluation for suspected CA. Methods and results We enrolled 93 suspected CA patients. Patients underwent a complete diagnostic work up. After diagnostic process 82 patients resulted affected by certain CA (20 AL and 62 TTR), while 11 subjects showed left ventricular hypertrophy (LVH) not caused by CA. 99mTc-HMDP cardiac uptake was evaluated using the Perugini visual score while the modified Janssen score was used for LR estimation (grade 0 no uptake, grade 1 less than ribs, grade 2 more than ribs). Results 99mTc-HMDP LR was observed in 1/20 AL patient (5%), while 36/62 (58%) TTR patients showed LR with 29 grade 1 (47%) and 7 grade 2 (11%). No LR was observed in patients with LVH and no CA. LR was not evident in patients without HR, present in 1/3 (33%) of the patients with Perugini 1 HR and 11/24 (46%) and 26/36 (72%) of the patients showing respectively a Perugini 2 and a Perugini 3. Conclusion 99mTc-HMDP scintigraphy shows LR in about 60% of TTR subjects, related to the grade of HR. In AL amyloidosis LR is less frequent than in TTR amyloidosis suggesting an aetiological tropism that seems comparable to the already known TTR related cardiac tropism. |
| Databáze: | OpenAIRE |
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