In vivo visualization of amyloid deposits in the heart with 11C-PIB and PET.

Abstract

UNLABELLED:

Cardiac amyloidosis is a differential diagnosis in heart failure and is associated with high mortality. There is currently no noninvasive imaging test available for specific diagnosis. N-[methyl-(11)C]2-(4'-methylamino-phenyl)-6-hydroxybenzothiazole ((11)C-PIB) PET is used in the evaluation of brain amyloidosis. We evaluated the potential use of (11)C-PIB PET in systemic amyloidosis affecting the heart.

METHODS:

Patients (n = 10) diagnosed with systemic amyloidosis-including heart involvement of either monoclonal immunoglobulin light-chain (AL) or transthyretin (ATTR) type-and healthy volunteers (n = 5) were investigated with PET/CT using (11)C-PIB to study cardiac amyloid deposits and with (11)C-acetate to measure myocardial blood flow to study the impact of global and regional perfusion on PIB retention.

RESULTS:

Myocardial (11)C-PIB uptake was visually evident in all patients 15-25 min after injection and was not seen in any volunteer. A significant difference in (11)C-PIB retention in the heart between patients and healthy controls was found. The data indicate that myocardial amyloid deposits in patients diagnosed with systemic amyloidosis could be visualized with (11)C-PIB. No correlation between (11)C-PIB retention index and myocardial blood flow as measured with (11)C-acetate was found on the global level, whereas a positive correlation on the segmental level was seen in a single patient.

CONCLUSION:

(11)C-PIB and PET could be a method to study systemic amyloidosis of type AL and ATTR affecting the heart and should be investigated further both as a diagnostic tool and as a noninvasive method for treatment follow-up.

• Authors: Gunnar Antoni, Mark Lubberink, Sergio Estrada, Jan Axelsson, Kristina Carlson, Lars Lindsjö, Tanja Kero, Bengt Långström, Sven-Olof Granstam, Sara Rosengren, Ola Vedin, Cecilia Wassberg, Gerhard Wikström, Per Westermark, Jens Sörensen
• Journal: Journal of nuclear medicine : official publication, Society of Nuclear Medicine (J Nucl Med) Vol. 54 Issue 2 Pg. 213-20 (Feb 2013) ISSN: 1535-5667 [Electronic] United States
• PMID: 23238792 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• 2-(4'-(methylamino)phenyl)-6-hydroxybenzothiazole
• Amyloid
• Aniline Compounds
• Benzothiazoles
• Carbon Isotopes
• Prealbumin
• Thiazoles

Topics

• Aged
• Amyloid (metabolism)
• Amyloidosis (diagnostic imaging)
• Aniline Compounds
• Benzothiazoles (pharmacology)
• Carbon Isotopes (pharmacology)
• Case-Control Studies
• Female
• Heart (diagnostic imaging, physiology)
• Humans
• Image Processing, Computer-Assisted
• Male
• Middle Aged
• Myocardium (metabolism)
• Nuclear Medicine (methods)
• Positron-Emission Tomography (methods)
• Prealbumin (metabolism)
• Thiazoles
• Tomography, X-Ray Computed (methods)