Cardiac Amyloid Imaging with 18F-Florbetaben PET: A Pilot Study.
Our aim was to determine the feasibility of18F-florbetaben PET in diagnosing cardiac amyloidosis.


METHODS
18F-florbetaben PET was performed on 14 patients: 5 amyloid light chain, 5 amyloid transthyretin, and 4 control with hypertensive heart disease. Qualitative and quantitative assessments of18F-florbetaben activity were performed using the SUVmeanof the left ventricular myocardium and blood pool and calculation of target-to-background SUV ratio. Myocardial18F-forbetaben retention was also calculated as the percentage mean myocardial SUV change between 0 and 5 min and 15 and 20 min after radiotracer injection. Global left ventricular longitudinal and right ventricular free wall longitudinal strain were calculated using 2-dimensional speckle-tracking echocardiography.


RESULTS
Target-to-background SUV ratio and percentage myocardial18F-forbetaben retention were higher in amyloid patients than in hypertensive controls. A cutoff of 40% was able to differentiate between cardiac amyloid patients and hypertensive controls. Percentage myocardial18F-forbetaben retention was an independent determinant of both global left ventricular longitudinal and right ventricular free wall longitudinal strain via an inverse curve relationship.


CONCLUSIONS
18F-florbetaben PET imaging can accurately identify and differentiate between cardiac amyloidosis and hypertensive heart disease. Percentage myocardial18F-florbetaben retention was an independent determinant of myocardial dysfunction in cardiac amyloidosis.
Medical Imaging Department, Princess Alexandra Hospital, Brisbane, Australia phil.law.au@gmail.com.|School of Medicine, University of Queensland, Brisbane, Australia.
W Phillip
WP
Law
School of Medicine, University of Queensland, Brisbane, Australia.|Cardiology Department, Princess Alexandra Hospital, Brisbane, Australia; and.
William Y S
WY
Wang
Cardiology Department, Princess Alexandra Hospital, Brisbane, Australia; and.
Peter T
PT
Moore
School of Medicine, University of Queensland, Brisbane, Australia.|Amyloidosis Centre, Princess Alexandra Hospital, Brisbane, Australia.
Peter N
PN
Mollee
School of Medicine, University of Queensland, Brisbane, Australia.|Cardiology Department, Princess Alexandra Hospital, Brisbane, Australia; and.
Arnold C T
AC
Ng
D000328:Adult; D000368:Aged; D000682:Amyloid / Q000378:metabolism*; D000686:Amyloidosis / Q000000981:diagnostic imaging / Q000378:metabolism*; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000378:metabolism*; D003937:Diagnosis, Differential; D005260:Female; D005462:Fluorine Radioisotopes / Q000493:pharmacokinetics; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000378:metabolism; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D057054:Molecular Imaging / Q000379:methods*; D010865:Pilot Projects; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013747:Tetrabenazine / Q000031:analogs & derivatives* / Q000493:pharmacokinetics
D000682:Amyloid; D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; C549477:florbenazine F 18; D013747:Tetrabenazine
amyloidosis; echocardiography; florbetaben; positron emission tomography