title: In vivo visualization of amyloid deposits in the heart with 11C-PIB and PET.
abstract: 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.
  
  
  CONCLUSIONS
  (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.affiliation: Platform for Preclinical PET, Department of Medicinal Chemistry, Uppsala University, Uppsala, Sweden. Gunnar.Antoni@akademiska.se
authors.forename: Gunnar
authors.initials: G
authors.lastname: Antoni
authors.forename: Mark
authors.initials: M
authors.lastname: Lubberink
authors.forename: Sergio
authors.initials: S
authors.lastname: Estrada
authors.forename: Jan
authors.initials: J
authors.lastname: Axelsson
authors.forename: Kristina
authors.initials: K
authors.lastname: Carlson
authors.forename: Lars
authors.initials: L
authors.lastname: Lindsjö
authors.forename: Tanja
authors.initials: T
authors.lastname: Kero
authors.forename: Bengt
authors.initials: B
authors.lastname: Långström
authors.forename: Sven-Olof
authors.initials: SO
authors.lastname: Granstam
authors.forename: Sara
authors.initials: S
authors.lastname: Rosengren
authors.forename: Ola
authors.initials: O
authors.lastname: Vedin
authors.forename: Cecilia
authors.initials: C
authors.lastname: Wassberg
authors.forename: Gerhard
authors.initials: G
authors.lastname: Wikström
authors.forename: Per
authors.initials: P
authors.lastname: Westermark
authors.forename: Jens
authors.initials: J
authors.lastname: Sörensen
mesh_terms: D000368:Aged; D000682:Amyloid / Q000378:metabolism*; D000686:Amyloidosis / Q000000981:diagnostic imaging*; D000814:Aniline Compounds; D052160:Benzothiazoles / Q000494:pharmacology*; D002247:Carbon Isotopes / Q000494:pharmacology*; D016022:Case-Control Studies; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging* / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D009683:Nuclear Medicine / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods*; D011228:Prealbumin / Q000378:metabolism; D013844:Thiazoles; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: C475519:2-(4'-(methylamino)phenyl)-6-hydroxybenzothiazole; D000682:Amyloid; D000814:Aniline Compounds; D052160:Benzothiazoles; D002247:Carbon Isotopes; D011228:Prealbumin; D013844:Thiazoles