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Review
. 2021 May 30;11(6):996.
doi: 10.3390/diagnostics11060996.

Nuclear Imaging for the Diagnosis of Cardiac Amyloidosis in 2021

Weijia Li  1 , Dipan Uppal  1 , Yu-Chiang Wang  1 , Xiaobo Xu  1 , Damianos G Kokkinidis  2 , Mark I Travin  3 , James M Tauras  4
Affiliations
Review

Nuclear Imaging for the Diagnosis of Cardiac Amyloidosis in 2021

Weijia Li et al. Diagnostics (Basel). .

Abstract

Cardiac amyloidosis is caused by the deposition of misfolded protein fibrils into the extracellular space of the heart. The diagnosis of cardiac amyloidosis remains challenging because of the heterogeneous manifestations of the disease. There are many different types of amyloidosis with light-chain (AL) amyloidosis and transthyretin (ATTR) amyloidosis being the most common types of cardiac amyloidosis. Endomyocardial biopsy is considered the gold standard for diagnosing cardiac amyloidosis and differentiating amyloid subtypes, but its use is limited because of the invasive nature of the procedure, with risks for complications and the need for specialized training and centers to perform the procedure. Radionuclide cardiac imaging has recently become the most commonly performed test for the diagnosis of ATTR amyloidosis but is of limited value for the diagnosis of AL amyloidosis. Positron emission tomography has been increasingly used for the diagnosis of cardiac amyloidosis and its applications are expected to expand in the future. Imaging protocols are under refinement to achieve better quantification of the disease burden and prediction of prognosis.

Keywords: cardiac amyloidosis; cardiac scintigraphy; positron emission tomography.

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Conflict of interest statement

James M. Tauras served as site principal investigator for several cardiac amyloidosis clinical trials and has received honoraria from Eidos Therapeutics, Inc., and Pfizer. There are no other disclosures relevant to this article.

Figures

Figure 1
Figure 1
Illustration of nuclear imaging modalities for cardiac amyloidosis.
See this image and copyright information in PMC

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