The role of serial 99mTc-DPD scintigraphy in monitoring cardiac transthyretin amyloidosis
The role of serial 99mTc-DPD scintigraphy in monitoring cardiac transthyretin amyloidosis
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.
Amyloidosis, DPD, SPECT, cardiomyopathy, quantitation, transthyretin
1-12
Ross, James C
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Hutt, David F
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Burniston, Maria
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Grigore, Simona F
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Fontana, Marianna
adef3b76-656f-4dcf-b97b-eb6fe63fdf79
Page, Joanne
6f06c4a6-1208-4b80-b4c6-27a22d438ae0
Hawkins, Philip N
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Gilbertson, Janet A
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Rowczenio, Dorota
58a4520f-aaad-415b-82f5-a768abccbd6d
Gillmore, Julian D
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27 October 2021
Ross, James C
01f0b1a4-7f20-4283-b0b4-6b9c8534170e
Hutt, David F
28a0b183-4a99-4608-a137-75820a4578e3
Burniston, Maria
e944aab8-b8a4-4c94-ab81-58bfcd3eecda
Grigore, Simona F
ed4fe24c-a246-41e2-bf68-744b7786f0b8
Fontana, Marianna
adef3b76-656f-4dcf-b97b-eb6fe63fdf79
Page, Joanne
6f06c4a6-1208-4b80-b4c6-27a22d438ae0
Hawkins, Philip N
0dfbe820-90ce-41a3-b8ec-74f0cf5912dd
Gilbertson, Janet A
dd5703a5-43b9-44c3-9cd0-0c1b4cc3270a
Rowczenio, Dorota
58a4520f-aaad-415b-82f5-a768abccbd6d
Gillmore, Julian D
74447045-8518-4625-b2d1-9a74579c4daa
Ross, James C, Hutt, David F, Burniston, Maria, Grigore, Simona F, Fontana, Marianna, Page, Joanne, Hawkins, Philip N, Gilbertson, Janet A, Rowczenio, Dorota and Gillmore, Julian D
(2021)
The role of serial 99mTc-DPD scintigraphy in monitoring cardiac transthyretin amyloidosis.
Amyloid: The Journal of Protein Folding Disorders, .
(doi:10.1080/13506129.2021.1991302).
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.
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More information
Accepted/In Press date: 2021
e-pub ahead of print date: 27 October 2021
Published date: 27 October 2021
Additional Information:
Publisher Copyright:
© 2021 Informa UK Limited, trading as Taylor & Francis Group.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
Keywords:
Amyloidosis, DPD, SPECT, cardiomyopathy, quantitation, transthyretin
Identifiers
Local EPrints ID: 453017
URI: http://eprints.soton.ac.uk/id/eprint/453017
ISSN: 1350-6129
PURE UUID: 5ce4c95d-02c5-4b67-9862-21527a72adb5
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Date deposited: 07 Jan 2022 17:04
Last modified: 17 Mar 2024 04:03
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Author:
David F Hutt
Author:
Maria Burniston
Author:
Simona F Grigore
Author:
Marianna Fontana
Author:
Joanne Page
Author:
Philip N Hawkins
Author:
Janet A Gilbertson
Author:
Dorota Rowczenio
Author:
Julian D Gillmore
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