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Significance of 11C-PIB PET/CT in cardiac amyloidosis compared with 99mTc-aprotinin scintigraphy: A pilot study

  • Ryogo Minamimoto
  • Toru Awaya
  • Kentaro Iwama
  • Masatoshi Hotta
  • Kazuhiko Nakajima
  • Risen Hirai
  • Osamu Okazaki
  • Yukio Hiroi
Original Article

Abstract

Background

This study was to investigate the significance of 11C-Pittsburgh B (PIB) PET/CT in patients with suspected cardiac amyloidosis compared with 99mTc-aprotinin scintigraphy.

Methods

Thirteen consecutive patients with suspected cardiac amyloidosis were considered for enrolment in this prospective pilot study. Participants were scheduled to undergo a series of 11C-PIB PET/CT and 99mTc-aprotinin within a 2-month period. Finally, we evaluated nine cases who underwent both imaging modalities, and compared imaging results with clinical and pathological results and prognosis.

Results

Six of the 9 patients who underwent both imaging modalities were diagnosed with amyloidosis, of whom 3 patients were diagnosed with cardiac amyloidosis from endomyocardial biopsy. These 3 patients with positive 11C-PIB uptake at the left ventricle wall showed worsening of cardiac function progressing in the short term or death caused by acute exacerbation of chronic heart failure. Six of 8 patients with positive uptake on 99mTc-aprotinin presented with amyloid deposition in the left ventricle wall, but symptoms remained stable if results of 11C-PIB were not positive.

Conclusion

In a small sample of subjects, the present study showed that 11C-PIB accumulation in myocardium indicated cardiac amyloidosis with poor prognosis. Uptake of 11C-PIB may be related to progressive amyloid deposition to the heart and can predict patient prognosis.

Keywords

Amyloidosis Pittsburgh compound B Aprotinin 

Abbreviations

PIB

Pittsburgh B

PET/CT

Positron emission tomography/ computed tomography

SPECT/CT

Single-photon emission computed tomography/computed tomography

VOIs

Volume of interests

SUV

Standardized uptake value

ATTR

TTR-related amyloidosis

Notes

Disclosure

None of the authors have any conflicts of interest to disclose.

Supplementary material

12350_2018_1260_MOESM1_ESM.pptx (6.4 mb)
Electronic supplementary material 1 (PPTX 6533 kb)

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Copyright information

© American Society of Nuclear Cardiology 2018

Authors and Affiliations

  • Ryogo Minamimoto
    • 1
  • Toru Awaya
    • 2
  • Kentaro Iwama
    • 2
  • Masatoshi Hotta
    • 1
  • Kazuhiko Nakajima
    • 1
  • Risen Hirai
    • 3
  • Osamu Okazaki
    • 2
  • Yukio Hiroi
    • 2
  1. 1.Division of Nuclear Medicine, Department of RadiologyNational Center for Global Health and MedicineTokyoJapan
  2. 2.Department of Cardiovascular MedicineNational Center for Global Health and MedicineTokyoJapan
  3. 3.Division of Hematology, Internal medicineTokyo Kita Medical CenterTokyoJapan

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