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Osborne DR, Acuff SN, Stuckey A, et al. A Routine PET/CT Protocol with Streamlined Calculations for Assessing Cardiac Amyloidosis Using (18)F-Florbetapir. Front Cardiovasc Med. 2015;2:23doi: 10.3389/fcvm.2015.00023.
Osborne, D. R., Acuff, S. N., Stuckey, A., & Wall, J. S. (2015). A Routine PET/CT Protocol with Streamlined Calculations for Assessing Cardiac Amyloidosis Using (18)F-Florbetapir. Frontiers in cardiovascular medicine, 223. https://doi.org/10.3389/fcvm.2015.00023
Osborne, Dustin R, et al. "A Routine PET/CT Protocol with Streamlined Calculations for Assessing Cardiac Amyloidosis Using (18)F-Florbetapir." Frontiers in cardiovascular medicine vol. 2 (2015): 23. doi: https://doi.org/10.3389/fcvm.2015.00023
Osborne DR, Acuff SN, Stuckey A, Wall JS. A Routine PET/CT Protocol with Streamlined Calculations for Assessing Cardiac Amyloidosis Using (18)F-Florbetapir. Front Cardiovasc Med. 2015 May 08;2:23. doi: 10.3389/fcvm.2015.00023. eCollection 2015. PMID: 26664895; PMCID: PMC4671357.
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Front Cardiovasc Med. 2015 May 08;2:23. doi: 10.3389/fcvm.2015.00023. eCollection 2015.

A Routine PET/CT Protocol with Streamlined Calculations for Assessing Cardiac Amyloidosis Using (18)F-Florbetapir.

Frontiers in cardiovascular medicine

Dustin R Osborne, Shelley N Acuff, Alan Stuckey, Jonathan S Wall

Affiliations

  1. Molecular Imaging and Translational Research Program, Department of Radiology, Graduate School of Medicine, University of Tennessee , Knoxville, TN , USA.
  2. Amyloid and Cancer Theranostics Program, Department of Medicine, Graduate School of Medicine, University of Tennessee , Knoxville, TN , USA.

PMID: 26664895 PMCID: PMC4671357 DOI: 10.3389/fcvm.2015.00023

Abstract

INTRODUCTION: Cardiac amyloidosis is a rare condition characterized by the deposition of well-structured protein fibrils, proteoglycans, and serum proteins as amyloid. Recent work has shown that it may be possible to use (18)F-Florbetapir to image cardiac amyloidosis. Current methods for assessment include invasive biopsy techniques. This work enhances foundational work by Dorbala et al. by developing a routine imaging and analysis protocol using (18)F-Florbetapir for cardiac amyloid assessment.

METHODS: Eleven patients, three healthy controls and eight myloid positive patients, were imaged using (18)F-Florbetapir to assess cardiac amyloid burden. Four of the patients were also imaged using (82)Rb-Chloride to evaluate possible (18)F-Florbetapir retention because of reduced myocardial blood flow. Quantitative methods using modeling, SUVs and SUV ratios were used to define a new streamlined clinical imaging protocol that could be used routinely and provide patient stratification.

RESULTS: Quantitative analysis of (18)F-Florbetapir cardiac amyloid data were compiled from a 20-min listmode protocol with data histogrammed into two static images at 0-5, 10-15, or 15-20 min. Data analysis indicated the use of SUVs or ratios of SUVs calculated from regions draw in the septal wall were adequate in identification of all healthy controls from amyloid positive patients in this small cohort. Additionally, we found that it may be possible to use this method to differentiate patients suffering from AL vs. TTR amyloid.

CONCLUSION: This work builds on the seminal work by Dorbala et al. by describing a short (18)F-Florbetapir imaging protocol that is suitable for routine clinical use and uses a simple method for quantitative analysis of cardiac amyloid disease.

Keywords: Florbetapir; PET/CT; amyloid; amyloidosis; cardiac

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