What is the role of nuclear imaging in the workup of cardiac amyloidosis?

Updated: Mar 25, 2020
  • Author: Gyanendra K Sharma, MD, FACC, FASE; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Answer

Nuclear imaging was not typically used for the diagnosis of amyloidosis. Increased uptake of radio-labeled technetium has been reported in patients with cardiac amyloidosis and correlates well with cardiac involvement. It cannot be used for early detection of the disease. [61, 62] Technetium-99m pyrophosphate scintigraphy (99mTc-PYP) is used to differentiate ATTR from AL with a sensitivity of 97% and specificity of 100%. [63]

Radiolabeled serum amyloid P (SAP) component scintigraphy

SAP component plasma glycoprotein is seen in all types of amyloid deposits. After intravenous injection of radiolabeled SAP, scanning is done to assess its distribution and extent of organ involvement. This method cannot be used for evaluation of cardiac amyloidosis because of the heart's movement, but it is of value in assessment of systemic amyloidosis. [64]


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