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Cardiac amyloidosis imaging with amyloid positron emission tomography: A systematic review and meta-analysis

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Recent progress in amyloid positron emission tomography (PET) has enabled the targeted imaging of cardiac amyloidosis with accuracy. We performed a systematic review and meta-analysis on the diagnostic performance of cardiac amyloidosis using amyloid PET.

Methods

A systematic search was performed using key words: cardiac amyloidosis, amyloid, and PET. We estimated the pooled sensitivity, specificity, positive and negative likelihood ratio (LR), and diagnostic odds ratio (DOR). Furthermore, the semiquantitative parameters of PET were evaluated to diagnose cardiac amyloidosis and discern its type [systemic light chain amyloidosis (AL) vs transthyretin amyloidosis (ATTR)] using the pooled standardized mean difference (SMD).

Results

In total, six eligible studies with a total of 98 subjects were included in this meta-analysis. The pooled sensitivity was 0.95, the specificity was 0.98, positive LR was 10.130, negative LR was 0.1, and DOR was 148.83. The semiquantitative parameters of amyloid PET showed significantly higher values for cardiac amyloidosis patients than those for controls (pooled SMD = 1.42; P < .001), and in AL than ATTR (pooled SMD = 0.96; P < .001).

Conclusion

Amyloid PET imaging can be a useful method for diagnosing cardiac amyloidosis. The semiquantitative parameters of amyloid PET can help diagnose cardiac amyloidosis and discern its type.

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Abbreviations

AL:

Systemic light chain amyloidosis

ATTR:

Transthyretin amyloidosis

PET:

Positron emission tomography

PIB:

Pittsburgh compound B

LR:

Likelihood ratio

DOR:

Diagnostic odds ratio

CI:

Confidence interval

SMD:

Standardized mean difference

RI:

Retention index

TBR:

Tumor-to-background ratio

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Authors and Affiliations

  1. Department of Family Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea

    Yong Joong Kim MD

  2. Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea

    Sejin Ha MD & Yong-il Kim MD, PhD

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  1. Yong Joong Kim MD
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Correspondence to Yong-il Kim MD, PhD.

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Kim, Y.J., Ha, S. & Kim, Yi. Cardiac amyloidosis imaging with amyloid positron emission tomography: A systematic review and meta-analysis. J. Nucl. Cardiol. 27, 123–132 (2020). https://doi.org/10.1007/s12350-018-1365-x

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