Cardiac scintigraphy with 99mTc-diphosphonates in cardiac amyloidosis

Rev Esp Med Nucl Imagen Mol (Engl Ed). 2020 Jul-Aug;39(4):254-266. doi: 10.1016/j.remn.2020.03.007. Epub 2020 Jun 6.
[Article in English, Spanish]

Abstract

Transthyretin cardiac amyloidosis (ATTR) has traditionally been considered a rare, difficult-to-diagnose and untreatable disease. However, its prevalence is known to be greater than what was previously thought, non-invasive diagnostic methods are available, and that effective treatments are emerging. In this context, cardiac scintigraphy (CS) with 99mTc-labelled diphosphonates has aroused a noticeable surge in interest by demonstrating high sensitivity and specificity for the reliable, non-invasive diagnosis of ATTR. By way of a guide, this article aims to identify the critical components in the performance of CS that are useful in everyday clinical practice and, thus, help specialists use optimal radiopharmaceuticals, obtain the most appropriate images, interpret the results thereof, and acquaint themselves with those clinical scenarios in which it is convenient to perform CS.

Keywords: (99m)Tc-difosfonatos; (99m)Tc-diphosphonates; ATTR; Amiloidosis cardíaca; Cardiac amyloidosis; Gammagrafía; Scintigraphy.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Amyloid / chemistry
  • Amyloid Neuropathies, Familial / complications
  • Amyloid Neuropathies, Familial / diagnostic imaging*
  • Bone and Bones / diagnostic imaging
  • Calcinosis / diagnostic imaging
  • Calcinosis / etiology
  • Cardiomyopathies / complications
  • Cardiomyopathies / diagnostic imaging*
  • Clinical Protocols
  • Diphosphonates* / administration & dosage
  • Diphosphonates* / pharmacokinetics
  • Forms and Records Control
  • Heart / diagnostic imaging
  • Heart Failure / etiology
  • Humans
  • Mass Screening
  • Myocardium / metabolism
  • Myocardium / pathology
  • Organ Specificity
  • Organotechnetium Compounds* / administration & dosage
  • Organotechnetium Compounds* / pharmacokinetics
  • Prealbumin / genetics
  • Prognosis
  • Radionuclide Imaging / methods*
  • Radiopharmaceuticals* / administration & dosage
  • Radiopharmaceuticals* / pharmacokinetics
  • Technetium Tc 99m Medronate / administration & dosage
  • Technetium Tc 99m Medronate / analogs & derivatives*
  • Technetium Tc 99m Medronate / pharmacokinetics
  • Technetium Tc 99m Pyrophosphate* / administration & dosage
  • Technetium Tc 99m Pyrophosphate* / pharmacokinetics
  • Whole Body Imaging / methods

Substances

  • Amyloid
  • Diphosphonates
  • Organotechnetium Compounds
  • Prealbumin
  • Radiopharmaceuticals
  • TTR protein, human
  • technetium Tc 99m 1,1-diphosphonopropane-2,3-dicarboxylic acid
  • Technetium Tc 99m Pyrophosphate
  • technetium Tc 99m hydroxymethylene diphosphonate
  • Technetium Tc 99m Medronate

Supplementary concepts

  • Amyloidosis, Hereditary, Transthyretin-Related