Nucl Med Mol Imaging.  2021 Apr;55(2):61-70. 10.1007/s13139-020-00681-4.

Nuclear Imaging for Cardiac Amyloidosis: Bone Scan, SPECT/CT, and Amyloid-Targeting PET

Affiliations
  • 1Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Republic of Korea
  • 2Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, 06351 Seoul, Republic of Korea

Abstract

Cardiac amyloidosis (CA) is a type of systemic amyloidosis, in which abnormal amyloid fibril is deposited in extracellular space of myocardium. Most common subtypes of CA are amyloidosis of immunoglobulin light chain (AL) and amyloidosis of transthyretin (ATTR). With increase in incidence of CA and development of new drugs, the needs of early and accurate diagnosis of CA are increasing. In CA, bone scan and SPECT/CT have long been used for diagnosis. Currently, bone scan is included in almost all practice guidelines as one of key diagnostic examinations for ATTR CA. In some specific scenarios, bone scan can be used as even a substitute for endomyocardial biopsy. Recently, amyloid-targeting PET that is used for Alzheimer dementia has also been attempted as an imaging method for CA. Although the study results are still insufficient, amyloid-targeting has shown promising potential as an imaging method for CA, particularly in AL. Here, imaging method and clinical application and implication of bone scan, SPECT/CT, and amyloid-targeting PET/CT in CA are reviewed.

Keyword

Cardiac amyloidosis; AL amyloidosis; ATTR amyloidosis; Bone scan; SPECT/CT; PET/CT
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