성균관의대 / 이주희, 김기현, 최준영*
Abstract
Although pathological confirmation is the gold standard for diagnosis of amyloidosis, there is a need for a relevant imaging modality to identify involved organs and evaluate disease extent. Thus, we prospectively investigated imaging findings of Tc-DPD scintigraphy in AL and ATTR amyloidosis.A total of 21 subjects with pathologically confirmed AL or ATTR amyloidosis were included. Pretreatment whole body Tc-DPD planar scanning and regional SPECT/CT were performed in all subjects. For allegedly involved organs, Tc-DPD uptake was visually and semi-quantitatively evaluated on a 4-point scale (grade 0: no uptake, 1: uptake less than spine, 2: uptake similar to spine, and 3: uptake greater than spine).There were 29 organs involved in AL and 12 in ATTR. Significant Tc-DPD uptake was found in 24 organs (sensitivity = 82.8%) in AL and 9 organs (sensitivity = 75.0%) in ATTR. Additional SPECT/CT was helpful to ensure abnormal DPD uptake in the involved organs, which was uncertain by attenuation in planar imaging. Degree of Tc-DPD uptake was significantly higher in ATTR compared with AL amyloidosis (P = .017). Diffuse soft tissue uptake with photon defects in the liver area was found only in ATTR amyloidosis.This study showed that Tc-DPD scintigraphy might have capacity to differentiate between AL and ATTR subtypes with good sensitivity in various organs involving primary systemic AL and ATTR amyloidosis. Additional SPECT/CT significantly improved the diagnostic efficacy of Tc-DPD scintigraphy.
Author information
Lee J1, Kim K2, Choi JO2, Kim SJ2, Jeon ES2, Choi JY1.
1
Departments of Nuclear Medicine.
2
Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
편집위원
Amyloidosis 감별에 뼈스캔 추적자인 Tc-99m DPD 이용 핵의학스캔에 유용하며, SPECT/CT를 추가적으로 시행하면 더 정확하게 진단이 가능함을 보여준 임상연구임. 핵의학 검사 활성화에 도움이 될 것으로 보이며, 심장관련 진료진 및 심장핵의학 의사에게 특히 관심을 끌 논문으로 생각됨.
2020-03-02 16:40:58