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Utility of technetium Tc 99m pyrophosphate bone scanning in cardiac amyloidosis.

Abstract
Thirty-four patients with amyloidosis proved by biopsy specimen were studied using technetium Tc 99m pyrophosphate scintigraphy to assess its utility in the diagnosis of amyloid heart involvement. Of 14 patients studied retrospectively, only three had intense uptake judged to be diagnostic of cardiac amyloidosis. In a prospective analysis of 20 patients with amyloidosis, all of whom had evidence of cardiac involvement by two-dimensional echocardiography, 17 had abnormal scans. Fourteen of the 17 scans had only 1+ or 2+ uptake, a finding that also was present in 15 of the 20 control patients (without amyloid heart disease). Only three of the 20 patients with cardiac amyloidosis had intense uptake that was considered unequivocal and diagnostic of amyloidosis. Of the five patients with biopsy specimen proof of endomyocardial amyloidosis, only one had intense uptake and one had no uptake. When intense uptake of technetium Tc 99m pyrophosphate is found in the heart of a patient, amyloidosis is highly likely. The technique, however, is not sufficiently sensitive to warrant routine screening of patients with amyloidosis or cardiomyopathies. Cross-sectional echocardiography is superior to pyrophosphate scintigraphy for recognition of cardiac amyloidosis.
AuthorsM A Gertz, M L Brown, M F Hauser, R A Kyle
JournalArchives of internal medicine (Arch Intern Med) Vol. 147 Issue 6 Pg. 1039-44 (Jun 1987) ISSN: 0003-9926 [Print] United States
PMID3036031 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Diphosphates
  • Technetium Tc 99m Pyrophosphate
  • Technetium
Topics
  • Aged
  • Aged, 80 and over
  • Amyloidosis (diagnosis, diagnostic imaging)
  • Cardiomyopathies (diagnosis, diagnostic imaging)
  • Diphosphates
  • Echocardiography
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Radionuclide Imaging
  • Retrospective Studies
  • Technetium
  • Technetium Tc 99m Pyrophosphate

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