Positron emission tomography in cardiac amyloidosis: current evidence and future directions

The increasing recognition of cardiac amyloidosis (CA) as a cause of heart failure, coupled with advancements in therapeutic options, has underscored the need for early detection. Positron emission tomography (PET) imaging emerged as a promising non-invasive tool for diagnosing and managing CA. This review provides a comprehensive analysis of current PET imaging techniques, focusing on radiotracers, including [¹¹C]Pittsburgh Compound B, [¹⁸F]Flutemetamol, [¹⁸F]Florbetapir, [¹⁸F]Florbetaben, [¹⁸F]-sodium fluoride, and [¹²⁴I]Evuzamitide. PET imaging's ability to differentiating CA subtypes and quantify amyloid burden contributes defining prognosis and aids in monitoring treatment response. However, standardizing imaging protocols and establishing definitive diagnostic thresholds remain challenging. As PET imaging continues to evolve, it promises to improve patient outcomes by facilitating earlier diagnosis, more accurate subtype differentiation, and better treatment monitoring in CA.