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Nuclear imaging for cardiac amyloidosis

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Abstract

Histological analysis of endomyocardial tissue is still the gold standard for the diagnosis of cardiac amyloidosis, but has its limitations. Accordingly, there is a need for non-invasive modalities to diagnose cardiac amyloidosis. Echocardiography and ultrasound and magnetic resonance imaging can show characteristics which may not be very specific for cardiac amyloid. Nuclear medicine has gained a precise role in this context: several imaging modalities have become available for the diagnosis and prognostic stratification of cardiac amyloidosis during the last two decades. The different classes of radiopharmaceuticals have the potential to bind different constituents of the amyloidotic infiltrates, with some relevant differences among the various aetiologic types of amyloidosis and the different organs and tissues involved. This review focuses on the background of the commonly used modalities, their present clinical applications, and future clinical perspectives in imaging patients with (suspected) cardiac amyloidosis. The main focus is on conventional nuclear medicine (bone scintigraphy, cardiac sympathetic innervation) and positron emission tomography.

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Conflict of interest

Dr. Noordzij, Dr. Glaudemans, Dr. Longhi, Dr. Slart, Dr. Lorenzini, Dr. Hazenberg and Dr. Rapezzi have no conflict of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands

    Walter Noordzij, Andor W. J. M. Glaudemans & Riemer H. J. A. Slart

  2. Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Bouke P. C. Hazenberg

  3. Department of Cardiology, University of Bologna, Bologna, Italy

    Simone Longhi, Massimiliano Lorenzini & Claudio Rapezzi

  4. S. Orsola, Malpighi Hospital, Bologna, Italy

    Simone Longhi, Massimiliano Lorenzini & Claudio Rapezzi

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  1. Walter Noordzij
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  2. Andor W. J. M. Glaudemans
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  6. Bouke P. C. Hazenberg
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Correspondence to Walter Noordzij.

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Noordzij, W., Glaudemans, A.W.J.M., Longhi, S. et al. Nuclear imaging for cardiac amyloidosis. Heart Fail Rev 20, 145–154 (2015). https://doi.org/10.1007/s10741-014-9463-6

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