Extracardiac (18)F-florbetapir imaging in patients with systemic amyloidosis: more than hearts and minds.
Extracardiac (18)F-florbetapir imaging in patients with systemic amyloidosis: more than hearts and minds.
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DOI：
10.1007/s00259-018-3995-2
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发表时间：
2018-07
影响因子：
9.1
通讯作者：
Wechalekar AD
中科院分区：
文献类型：
--
作者：
Wagner T;Page J;Burniston M;Skillen A;Ross JC;Manwani R;McCool D;Hawkins PN;Wechalekar AD
据报道，18F-Florbetapir在全身性轻链淀粉样变性（AL）患者中显示心脏摄取。本研究系统评估了心脏外部位经证实的系统性淀粉样变性患者对18F-氟倍他匹的摄取。17例确诊为心脏淀粉样变性的患者接受了18 F-氟倍他平PET/CT成像，其中15例为AL，2例为甲状腺素运载蛋白淀粉样变性（ATTR）。3例患者进行了重复扫描。所有患者在英国国家淀粉样变性中心进行了方案评估，包括123 I-血清淀粉样蛋白P成分（SAP）成像。评估18F-Florbetapir图像中示踪剂累积增加的区域，并产生标准化摄取值（SUV平均值）的时间-摄取曲线。所有17例患者均在一个或多个心外部位显示18F-氟倍他匹摄取。6例患者脾脏可见摄取（35%; 6/9，67%，123 I-SAP造影显示脾脏受累），脂肪11例（65%），舌8例（47%），腮腺8例（47%），咀嚼肌7例（41%），肺3例（18%），在晚期半身像上，肾脏2例（12%），计算18F-florbetapir脾滞留指数（SRI）。SRI >0.045在动态显像上检测脾淀粉样蛋白的灵敏度/敏感度（与123 I-SAP脾摄取相关，当前标准）为100%，在晚期半身显像上的灵敏度为66.7%，特异性为100%。在3名患者中观察到强烈的肺摄取，其中1名患者在既往高分辨率CT上有肺间质浸润，提示淀粉样蛋白沉积。重复成像显示所有3例患者的外观稳定，表明治疗反应无早期影响。18F-Florbetapir PET/CT是检测淀粉样蛋白沉积的心外部位的有前途的工具。18F-florbetapir PET/CT上心脏和脾脏摄取的组合（AL的标志）表明，该示踪剂有望成为AL的筛查工具。本文的在线版本（10.1007/s 00259 -018-3995-2）包含补充材料，可供授权用户使用。
18F-Florbetapir has been reported to show cardiac uptake in patients with systemic light-chain amyloidosis (AL). This study systematically assessed uptake of 18F-florbetapir in patients with proven systemic amyloidosis at sites outside the heart. Seventeen patients with proven cardiac amyloidosis underwent 18F-florbetapir PET/CT imaging, 15 with AL and 2 with transthyretin amyloidosis (ATTR). Three patients had repeat scans. All patients had protocolized assessment at the UK National Amyloidosis Centre including imaging with 123I-serum amyloid P component (SAP). 18F-Florbetapir images were assessed for areas of increased tracer accumulation and time–uptake curves in terms of standardized uptake values (SUVmean) were produced. All 17 patients showed 18F-florbetapir uptake at one or more extracardiac sites. Uptake was seen in the spleen in 6 patients (35%; 6 of 9, 67%, with splenic involvement on 123I-SAP scintigraphy), in the fat in 11 (65%), in the tongue in 8 (47%), in the parotids in 8 (47%), in the masticatory muscles in 7 (41%), in the lungs in 3 (18%), and in the kidney in 2 (12%) on the late half-body images. The 18F-florbetapir spleen retention index (SRI) was calculated. SRI >0.045 had 100% sensitivity/sensitivity (in relation to 123I-SAP splenic uptake, the current standard) in detecting splenic amyloid on dynamic imaging and a sensitivity of 66.7% and a specificity of 100% on the late half-body images. Intense lung uptake was seen in three patients, one of whom had lung interstitial infiltration suggestive of amyloid deposition on previous high-resolution CT. Repeat imaging showed a stable appearance in all three patients suggesting no early impact of treatment response. 18F-Florbetapir PET/CT is a promising tool for the detection of extracardiac sites of amyloid deposition. The combination of uptake in the heart and uptake in the spleen on 18F-florbetapir PET/CT, a hallmark of AL, suggests that this tracer holds promise as a screening tool for AL. The online version of this article (10.1007/s00259-018-3995-2) contains supplementary material, which is available to authorized users.
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影响因子：
3.6
作者：
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通讯作者：
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