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The role of serial 99mTc-DPD scintigraphy in monitoring cardiac transthyretin amyloidosis

Ross, James C; Hutt, David F; Burniston, Maria; Grigore, Simona F; Fontana, Marianna; Page, Joanne; Hawkins, Philip N; ... Gillmore, Julian D; + view all (2021) The role of serial 99mTc-DPD scintigraphy in monitoring cardiac transthyretin amyloidosis. Amyloid , 29 (1) pp. 38-49. 10.1080/13506129.2021.1991302. Green open access

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Abstract

Purpose: Cardiac transthyretin amyloidosis is a usually fatal form of restrictive cardiomyopathy for which clinical trials of treatments are ongoing. It is anticipated that quantitative nuclear medicine scintigraphy, which is experiencing growing interest, will soon be used to evaluate treatment efficacy. We investigated its utility for monitoring changes in disease load over a significant time period. Methods: Sixty-two treatment-naive patients underwent 99mTc-labelled 3,3-diphosphono-1,2propanodicarboxylic acid (99mTc-DPD) scintigraphy two to four times each over a five-year period. Quantitation of cardiac 99mTc-DPD retention was performed according to two established methods: measurement of heart-to-contralateral ratio (H/CL) in the anterior view (planar) and percentage of administered activity in the myocardium (SPECT). Results: In total 170 datasets were analysed. Increased myocardial retention of 99mTc-DPD was demonstrable as early as 12 months from baseline. Year-on-year progression across the cohort was observed using SPECT-based quantitation, though on 30 occasions (27.8%) the change in our estimate was negative. Conclusions: The spread of our results was notably high compared to the year-on-year increases. If left unaccounted for, variance may draw fallacious conclusions about changes in disease load. We therefore urge caution in drawing conclusions solely from nuclear medicine scintigraphy on a patient-by-patient basis, particularly across a short time period.

Type: Article
Title: The role of serial 99mTc-DPD scintigraphy in monitoring cardiac transthyretin amyloidosis
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1080/13506129.2021.1991302
Publisher version: https://doi.org/10.1080/13506129.2021.1991302
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Biochemistry & Molecular Biology, Medicine, General & Internal, Medicine, Research & Experimental, General & Internal Medicine, Research & Experimental Medicine, Amyloidosis, cardiomyopathy, DPD, quantitation, SPECT, transthyretin, CARPAL-TUNNEL-SYNDROME, HEART-FAILURE, DIAGNOSIS, ATTR, TRANSPLANTATION, DEPOSITION
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10150751
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