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Performance of 99mTc-aprotinin scintigraphy for diagnosing light chain (AL) cardiac amyloidosis confirmed by endomyocardial biopsy

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Light chain (AL) cardiac amyloidosis is associated with a poor prognosis. Diagnosing at an early stage is critical for treatment and the management of cardiac complication.

Purpose

We aimed to evaluate the diagnostic performance of 99mTc-aprotinin images in patients with AL cardiac amyloidosis.

Methods and Results

99mTc-aprotinin scintigraphy and endomyocardial biopsy were performed in 10 patients with suspected amyloidosis. Endomyocardial biopsy showed amyloid deposits in 5 of 10 patients. 99mTc-aprotinin (planer image) was positive in 4 of 5 patients who had amyloid deposits in endomyocardial biopsy. On the other hand, all 5 patients without amyloid deposits were negative in planer image. 99mTc-aprotinin (SPECT/CT image) was positive in all 5 patients who had amyloid deposits.

Conclusions

99mTc-aprotinin scintigraphy is valuable for the non-invasive diagnosis of AL cardiac amyloidosis.

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Abbreviations

AL:

Light chain

PYP:

Pyrophosphate

LGE-CMR:

Late gadolinium enhancement cardiac magnetic resonance

BJP:

Bence jones protein

λ:

lambda

κ:

kappa

ICD:

Implantable cardioverter defibrillation

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Acknowledgements

The authors are greatly thankful to the radiological technologist in nuclear medicine at National Center for Global Health and Medicine.

Disclosure

The authors declare that there is no conflict of interest.

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Authors and Affiliations

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

    Toru Awaya MD, Shuji Kubota MD, Masaya Yamamoto MD, Osamu Okazaki MD, PhD, Hisao Hara MD, PhD, Yukio Hiroi MD, PhD & Michiaki Hiroe MD, PhD

  2. Division of Cardiovascular Medicine, Toho University Medical Center Ohashi Hospital, Tokyo, Japan

    Toru Awaya MD & Masao Moroi MD, PhD

  3. Division of Nuclear Medicine, National Center for Global Health and Medicine, Tokyo, Japan

    Ryogo Minamimoto MD, PhD & Masatoshi Hotta MD

  4. Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan

    Kentaro Iwama MD

  5. Department of Hematology, Internal medicine Tokyo-Kita Medical Center, Tokyo, Japan

    Risen Hirai MD

Authors
  1. Toru Awaya MD
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  2. Ryogo Minamimoto MD, PhD
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  3. Kentaro Iwama MD
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  4. Shuji Kubota MD
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  5. Masatoshi Hotta MD
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  6. Risen Hirai MD
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  7. Masaya Yamamoto MD
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  8. Osamu Okazaki MD, PhD
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  9. Hisao Hara MD, PhD
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  10. Yukio Hiroi MD, PhD
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  11. Michiaki Hiroe MD, PhD
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  12. Masao Moroi MD, PhD
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Corresponding author

Correspondence to Toru Awaya MD.

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Awaya, T., Minamimoto, R., Iwama, K. et al. Performance of 99mTc-aprotinin scintigraphy for diagnosing light chain (AL) cardiac amyloidosis confirmed by endomyocardial biopsy. J. Nucl. Cardiol. 27, 1145–1153 (2020). https://doi.org/10.1007/s12350-019-01868-9

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  • DOI: https://doi.org/10.1007/s12350-019-01868-9

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