Bone scintigraphy imaging of cardiac amyloidosis

Issa Menge Kuria; Samuel Nguku Gitau; Khalid Bashir Makhdomi

doi:10.4103/wjnm.WJNM_9_19

World Journal of Nuclear Medicine, Table of Contents

CC BY-NC-ND 4.0 · World J Nucl Med 2019; 18(03): 314-316
DOI: 10.4103/wjnm.WJNM_9_19

Case Report

Bone scintigraphy imaging of cardiac amyloidosis

Authors

Issa Menge Kuria

Department of Imaging and Diagnostic Radiology, Aga Khan University Hospital, Nairobi, Kenya
Samuel Nguku Gitau

Department of Imaging and Diagnostic Radiology, Aga Khan University Hospital, Nairobi, Kenya
Khalid Bashir Makhdomi

Department of Imaging and Diagnostic Radiology, Aga Khan University Hospital, Nairobi, Kenya

Abstract

Transthyretin-related cardiac amyloidosis (ATTR) amyloidosis is an aggressive, rapidly progressive, and fatal disease, for which several promising therapies are in development. This condition is frequently underdiagnosed because of the limited specificity of echocardiography and the traditional requirement for histological diagnosis. It is well known that ^99mtechnetium-labeled bone scan radiotracers can localize in the myocardial amyloid deposits, but the use of this imaging modality to differentiate between the two subtypes has only lately been revisited. We report a case of a 76-year-old man with a clinical diagnosis of amyloidosis who underwent a bone scan that had features of ATTR amyloidosis. To the best of our knowledge, this is the first case report in Sub-Saharan Africa.

Keywords

AL - bone scintigraphy - cardiac amyloidosis - transthyretin ATTR

Full Text

References

References
1 Merlini G, Bellotti V. Molecular mechanisms of amyloidosis. N Engl J Med 2003;349:583-96.
2 Westermark P, Benson MD, Buxbaum JN, Cohen AS, Frangione B, Ikeda S, et al. Amyloid: Toward terminology clarification. Report from the Nomenclature Committee of the International Society of Amyloidosis. Amyloid 2005;12:1-4.
3 Vrana JA, Gamez JD, Madden BJ, Theis JD, Bergen HR 3rd, Dogan A. Classification of amyloidosis by laser microdissection and mass spectrometry-based proteomic analysis in clinical biopsy specimens. Blood 2009;114:4957-9.
4 Gillmore JD, Maurer MS, Falk RH, Merlini G, Damy T, Dispenzieri A, et al. Nonbiopsy diagnosis of cardiac transthyretin amyloidosis. Circulation 2016;133:2404-12.
5 Ruberg FL, Maurer MS, Judge DP, Zeldenrust S, Skinner M, Kim AY, et al. Prospective evaluation of the morbidity and mortality of wild-type and V122I mutant transthyretin amyloid cardiomyopathy: The transthyretin amyloidosis cardiac study (TRACS). Am Heart J 2012;164:222-80.
6 Rapezzi C, Quarta CC, Riva L, Longhi S, Gallelli I, Lorenzini M, et al. Transthyretin-related amyloidoses and the heart: A clinical overview. Nat Rev Cardiol 2010;7:398-408.
7 Ng B, Connors LH, Davidoff R, Skinner M, Falk RH. Senile systemic amyloidosis presenting with heart failure: A comparison with light chain-associated amyloidosis. Arch Intern Med 2005;165:1425-9.
8 FDA Approves New Treatment for Hereditary Transthyretin-Mediated Amyloidosis. Available from: https://www.mdedge.com/clinicalneurologynews/article/176617/rare-diseases/fda-approves-new-treatment-hereditary. [Last accessed on 2019 Jan 07].
9 Falk RH. Diagnosis and management of the cardiac amyloidoses. Circulation 2005;112:2047-60.
10 Ansari-Lari MA, Ali SZ. Fine-needle aspiration of abdominal fat pad for amyloid detection: A clinically useful test? Diagn Cytopathol 2004;30:178-81.
11 Zotero | Home. Available from: https://www.zotero.org/. [Last accessed on 2018 Jan 21].
12 Maurer MS. Noninvasive identification of ATTRwt cardiac amyloid: The re-emergence of nuclear cardiology. Am J Med 2015;128:1275-80.
13 Sachchithanantham S, Wechalekar AD. Imaging in systemic amyloidosis. Br Med Bull 2013;107:41-56.
14 Dubrey S, Ackermann E, Gillmore J. The transthyretin amyloidoses: Advances in therapy. Postgrad Med J 2015;91:439-48.
15 Sekijima Y, Kelly JW, Ikeda S. Pathogenesis of and therapeutic strategies to ameliorate the transthyretin amyloidoses. Curr Pharm Des 2008;14:3219-30.
16 Ali A, Turner DA, Rosenbush SW, Fordham EW. Bone scintigram in cardiac amyloidosis: A case report. Clin Nucl Med 1981;6:105-8.
17 Hutt DF, Fontana M, Burniston M, Quigley AM, Petrie A, Ross JC, et al. Prognostic utility of the Perugini grading of 99mTc-DPD scintigraphy in transthyretin (ATTR) amyloidosis and its relationship with skeletal muscle and soft tissue amyloid. Eur Heart J Cardiovasc Imaging 2017;18:1344-50.
18 Lu Y, Groth JV, Emmadi R. Cardiac amyloidosis detected on Tc-99m bone scan. Nucl Med Mol Imaging 2015;49:78-80.
19 Ak I, Vardareli E, Erdinĉ O, Kasapoǧlu E, Ata N. Myocardial Tc-99m MDP uptake on a bone scan in senile systemic amyloidosis with cardiac involvement. Clin Nucl Med 2000;25:826-7.
20 Bokhari S, Castaño A, Pozniakoff T, Deslisle S, Latif F, Maurer MS. (99m) Tc-pyrophosphate scintigraphy for differentiating light-chain cardiac amyloidosis from the transthyretin-related familial and senile cardiac amyloidoses. Circ Cardiovasc Imaging 2013;6:195-201.
21 Hutt DF, Quigley AM, Page J, Hall ML, Burniston M, Gopaul D, et al. Utility and limitations of 3,3-diphosphono-1,2-propanodicarboxylic acid scintigraphy in systemic amyloidosis. Eur Heart J Cardiovasc Imaging 2014;15:1289-98.