title: 99mTc-aprotinin scintigraphy in amyloidosis.
abstract: Changes in the amount and distribution of amyloid lesions have been difficult to monitor because they can usually be demonstrated only by evident symptoms or from a biopsy. The recent progress in the treatment of amyloidosis stresses the need for an early diagnosis and the need for noninvasive monitoring during the course of treatment. To validate (99m)Tc-aprotinin scintigraphy, we studied 23 consecutive patients with known or suspected amyloidosis.
  
  
  METHODS
  (99m)Tc-Aprotinin (500-700 MBq) was injected intravenously and whole-body scans, regional images, and SPECT tomograms were obtained 90 min after tracer injection.
  
  
  RESULTS
  Focal accumulations of (99m)Tc-aprotinin were seen in different organs of 22 patients with a total of 90 lesions, of which 20 were confirmed by biopsy or autopsy. Scintigraphy revealed "silent" amyloid deposits in at least 5 patients who later developed clinical symptoms. Physiologic uptake or excretion in liver and kidneys could not be differentiated from pathologic lesions in those organs.
  
  
  CONCLUSIONS
  (99m)Tc-Aprotinin scintigraphy appears to be a fairly sensitive and specific diagnostic modality in patients with suspected amyloidosis. The technique is noninvasive, and it entails a minimal stress to the patient and is useful for detection of a wide range of lesions.
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. besch@gentoftehosp.kbhamt.dk
authors.forename: Bente K
authors.initials: BK
authors.lastname: Schaadt
authors.forename: Helle W
authors.initials: HW
authors.lastname: Hendel
authors.forename: Peter
authors.initials: P
authors.lastname: Gimsing
authors.forename: Viggo
authors.initials: V
authors.lastname: Jønsson
authors.forename: Heidi
authors.initials: H
authors.lastname: Pedersen
authors.forename: Birger
authors.initials: B
authors.lastname: Hesse
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000686:Amyloidosis / Q000000981:diagnostic imaging* / Q000378:metabolism; D007611:Aprotinin / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds / Q000493:pharmacokinetics; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014915:Whole-Body Counting
chemical_list: D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C041381:technetium Tc 99m aprotinin; D007611:Aprotinin