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Amyloid imaging mismatch
Ryogo Minamimoto1, Kenji Ishii, Kazuo Kubota
1Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan. ryogominamimoto@yahoo.co.jp
Clinical Nuclear Medicine
|July 13, 2012
Summary
This study highlights a case of cardiac amyloidosis diagnosed using technetium-99m-labeled aprotinin SPECT imaging. Positron emission tomography with carbon-11-labeled Pittsburgh compound B (11C-PiB PET/CT) was used to evaluate brain amyloid, showing normal cardiac biodistribution.
Area of Science:
- Nuclear medicine
- Cardiology
- Neurology
Background:
- Systemic amyloidosis can affect the heart, leading to conduction abnormalities.
- Accurate diagnosis of cardiac amyloidosis is crucial for patient management.
Observation:
- An 82-year-old man with suspected systemic amyloidosis and complete atrioventricular block presented with cardiac symptoms.
- Vascular biopsy confirmed amyloid deposits.
- Technetium-99m-labeled aprotinin single-photon emission computed tomography (SPECT) showed increased uptake in the left ventricular wall.
Findings:
- 99mTc-aprotinin SPECT findings were consistent with cardiac amyloidosis.
- 11C-PiB PET/CT suggested Alzheimer disease but did not show abnormal myocardial uptake.
- Dynamic 11C-PiB PET imaging revealed transient myocardial uptake, indicating normal biodistribution.
Implications:
- 99mTc-aprotinin SPECT is a valuable tool for diagnosing cardiac amyloidosis.
- Discordant findings between SPECT and 11C-PiB PET/CT highlight the importance of choosing appropriate imaging agents.
- This case underscores the potential for amyloid deposition in both the heart and brain.
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