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

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Journal of Nuclear Cardiology Aims and scope

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.

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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

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Disclosure

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

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Authors and Affiliations

  1. Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjyuku-ku, Tokyo, 162-8655, Japan

    Ryogo Minamimoto MD, PhD, Masatoshi Hotta MD & Kazuhiko Nakajima

  2. Department of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan

    Toru Awaya MD, Kentaro Iwama MD, Osamu Okazaki MD, PhD & Yukio Hiroi MD, PhD

  3. Division of Hematology, Internal medicine, Tokyo Kita Medical Center, Tokyo, Japan

    Risen Hirai MD

Authors
  1. Ryogo Minamimoto MD, PhD
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  2. Toru Awaya MD
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  3. Kentaro Iwama MD
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  4. Masatoshi Hotta MD
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  5. Kazuhiko Nakajima
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  6. Risen Hirai MD
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  7. Osamu Okazaki MD, PhD
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  8. Yukio Hiroi MD, PhD
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Corresponding author

Correspondence to Ryogo Minamimoto MD, PhD.

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Funding supported by National Center for Global Health and Medicine.

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Minamimoto, R., Awaya, T., Iwama, K. et al. Significance of 11C-PIB PET/CT in cardiac amyloidosis compared with 99mTc-aprotinin scintigraphy: A pilot study. J. Nucl. Cardiol. 27, 202–209 (2020). https://doi.org/10.1007/s12350-018-1260-5

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  • DOI: https://doi.org/10.1007/s12350-018-1260-5

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