Measurement of liver and spleen interstitial volume in patients with systemic amyloid light-chain amyloidosis using equilibrium contrast CT
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Published on: March 24, 2023
Jason Yeung1, S Sivarajan2, T A Treibel3,4
1Centre for Medical Imaging, University College London, 250 Euston Road, London, NW1 2PG, UK. j.yeung88@hotmail.co.uk.
Objectives:
To investigate equilibrium contrast-enhanced CT (EQ-CT) measurement of extracellular volume fraction (ECV) in patients with systemic amyloid light-chain (AL) amyloidosis, testing the hypothesis that ECV becomes elevated in the liver and spleen and ECV correlates with other estimates of organ amyloid burden.
Methods:
26 patients with AL amyloidosis underwent EQ-CT, and ECV was measured in the liver and spleen. Patients also underwent serum amyloid P (SAP) component scintigraphy with grading of liver and spleen involvement. Mann-Whitney U test was used to test for a difference between patients with amyloid deposition (SAP grade 1-3) and those without (SAP grade 0). Variation in ECV across SAP grades was assessed using the Kruskal-Wallis test and association between ECV and SAP grades with Spearman correlation.
Results:
Mean ECV in the spleen and liver was significantly greater (p < 0.0005) in amyloidotic organs (SAP grade 1-3) [spleen, liver: 0.430, 0.375] compared with healthy tissues [spleen, liver: 0.304, 0.269]. ECV increased with increasing amyloid burden, showing positive correlation with SAP grade in both the liver (r = 0.758) and spleen (r = 0.867).
Conclusion:
In patients with systemic AL amyloidosis, EQ-CT can demonstrate increased spleen and liver ECV, which is associated with amyloid disease burden.
