Abstract

Background: Hereditary transthyretin amyloid (ATTRv) is a systemic amyloidosis with mainly neurological and cardiac symptoms. The aim of this study was to evaluate the outcome of [¹⁸F]Flutemetamol PET/CT-scan of the heart in long-term survivors with ATTRV30M amyloidosis.

Methods: Twenty-one patients with ATTRV30M amyloidosis and predominantly neurological symptoms, mainly negative on cardiac ^99mtechnetium-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD)-scintigraphy, were examined with a dynamic [¹⁸F]Flutemetamol PET/CT-scan. Five patients suffering from Alzheimer’s disease and one healthy individual served as controls. Volumes of interests were drawn over the intraventricular septum, lateral wall of the left ventricle and free wall of the right ventricle. Clinical records were reviewed for data from previous completed DPD-scintigraphy of the heart and echocardiography.

Results: Patients with ATTRv amyloidosis had a higher cardiac uptake than the control-group in all analysed regions of the heart and could be identified with high accuracy (sensitivity 88%, specificity 100%) in static image acquisition at 30 or 60 min. We found no correlation between cardiac [¹⁸F]Flutemetamol uptake and clinical variables.

Conclusion: In this small study of selected patients, cardiac [¹⁸F]Flutemetamol PET/CT could differentiate between healthy individuals and patients with ATTRV30M. [¹⁸F]Flutemetamol PET/CT imaging of amyloidosis in patients with a negative DPD-scintigraphy has a potential as a diagnostic method.

摘要

背景：遗传性甲状腺素转运蛋白（ATTRv）是一种系统性淀粉样变性病，主要表现为神经和心脏症状。这项研究的目的是评估ATTRV30M淀粉样变性的长期幸存者的心脏[ ¹⁸ F]氟美他莫PET / CT扫描的结果。

方法：对21例ATTRV30M淀粉样变性病且主要为神经系统症状（主要在心脏^99m -3-3,3-二膦酰基1,2-丙二羧酸（DPD）-闪烁显像阴性）的患者进行了动态[ ¹⁸ F]氟美他莫PET检查/CT扫描。作为对照的五名患有阿尔茨海默氏病的患者和一名健康个体。在脑室间隔，左心室侧壁和右心室自由壁上绘制感兴趣的体积。回顾了临床记录，以获取先前完成的DPD心脏闪烁显像和超声心动图检查的数据。

结果： ATTRv淀粉样变性患者在心脏的所有分析区域中的心脏摄取均高于对照组，并且可以在30或60分钟的静态图像采集中以高精度（灵敏度88％，特异性100％）进行识别。我们发现心脏[ ¹⁸ F]氟替莫尔的摄取与临床变量之间没有相关性。

结论：在这项针对特定患者的小型研究中，心脏[ ¹⁸ F]氟美他莫PET / CT可以区分健康个体和ATTRV30M患者。[ ¹⁸ F] Flutemetamol PET /患者淀粉样变性的CT成像具有负DPD-显像具有潜在的诊断方法。