Early-phase myocardial uptake intensity of99mTc-HMDP vs99mTc-DPD in patients with hereditary transthyretin-related cardiac amyloidosis.
This study sought to compare the intensity of early-phase myocardial uptake of two phosphonate-based radiotracers,99mTc-hydroxymethylene diphosphonate (HMDP) and99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD), in patients with hereditary transthyretin-related cardiac amyloidosis (TTR-CA).



Six patients with biopsy-proven diagnosis of TTR-CA and characteristic amyloid fibril composition underwent early-phase99mTc-HMDP myocardial scintigraphy as part of their routine workup; they were later assessed by99mTc-DPD scintigraphy after having signed informed written consent. Heart-to-mediastinum-ratio was measured at both time points as well as regional distribution on 17-segment analysis.



All patients had an H/M ratio >1.28 on both imaging.99mTc-DPD uptake was slightly higher than99mTc-HMDP uptake in 3 patients, but no statistical difference was found (P = 0.13). Regional distribution of the two radiotracers was well correlated on bull's eyes analysis, with only slight underestimation of99mTc-DPD uptake in the anterior/apical segments, compared with99mTc-HMDP.



99mTc-HMDP and99mTc-DPD show comparable myocardial uptake intensity on early-phase scintigraphy and can be used alternatively for the diagnosis of TTR-CA.
Mondor Amyloidosis Network, 94000, Créteil, France.|Department of Nuclear Medicine, AP-HP, Henri Mondor Hospital, 94000, Créteil, France.
Mukedaisi
M
Abulizi
Mondor Amyloidosis Network, 94000, Créteil, France.|Department of Nuclear Medicine, AP-HP, Henri Mondor Hospital, 94000, Créteil, France.|DHU ATVB, Paris Est University, 94000, Créteil, France.
Anne-Ségolène
AS
Cottereau
Mondor Amyloidosis Network, 94000, Créteil, France.|DHU ATVB, Paris Est University, 94000, Créteil, France.|Department of Cardiology, AP-HP, Henri Mondor Hospital, 51 Ave. du Mal de Lattre de Tassigny, 94000, Créteil, France.|INSERM U955, GRC Amyloid Research Institute, 94000, Créteil, France.
Aziz
A
Guellich
Mondor Amyloidosis Network, 94000, Créteil, France.|Department of Nuclear Medicine, AP-HP, Henri Mondor Hospital, 94000, Créteil, France.
Stéphanie
S
Vandeventer
Mondor Amyloidosis Network, 94000, Créteil, France.|DHU ATVB, Paris Est University, 94000, Créteil, France.|Department of Cardiology, AP-HP, Henri Mondor Hospital, 51 Ave. du Mal de Lattre de Tassigny, 94000, Créteil, France.|INSERM U955, GRC Amyloid Research Institute, 94000, Créteil, France.
Arnault
A
Galat
Mondor Amyloidosis Network, 94000, Créteil, France.|Department of Nuclear Medicine, AP-HP, Henri Mondor Hospital, 94000, Créteil, France.
Axel
A
Van Der Gucht
Mondor Amyloidosis Network, 94000, Créteil, France.|DHU ATVB, Paris Est University, 94000, Créteil, France.|INSERM U955, GRC Amyloid Research Institute, 94000, Créteil, France.|Department of Neurology, AP-HP, Henri Mondor Hospital, 94000, Créteil, France.
Violaine
V
Plante-Bordeneuve
Mondor Amyloidosis Network, 94000, Créteil, France.|DHU ATVB, Paris Est University, 94000, Créteil, France.|Department of Cardiology, AP-HP, Henri Mondor Hospital, 51 Ave. du Mal de Lattre de Tassigny, 94000, Créteil, France.|INSERM U955, GRC Amyloid Research Institute, 94000, Créteil, France.
Jean-Luc
JL
Dubois-Randé
Mondor Amyloidosis Network, 94000, Créteil, France.|DHU ATVB, Paris Est University, 94000, Créteil, France.|Department of Cardiology, AP-HP, Henri Mondor Hospital, 51 Ave. du Mal de Lattre de Tassigny, 94000, Créteil, France.|INSERM U955, GRC Amyloid Research Institute, 94000, Créteil, France.
Diane
D
Bodez
Mondor Amyloidosis Network, 94000, Créteil, France.|Department of Nuclear Medicine, AP-HP, Henri Mondor Hospital, 94000, Créteil, France.|DHU ATVB, Paris Est University, 94000, Créteil, France.
Jean
J
Rosso
Mondor Amyloidosis Network, 94000, Créteil, France.|DHU ATVB, Paris Est University, 94000, Créteil, France.|Department of Cardiology, AP-HP, Henri Mondor Hospital, 51 Ave. du Mal de Lattre de Tassigny, 94000, Créteil, France.|INSERM U955, GRC Amyloid Research Institute, 94000, Créteil, France.
Thibaud
T
Damy
Mondor Amyloidosis Network, 94000, Créteil, France. emmanuel.itti@aphp.fr.|Department of Nuclear Medicine, AP-HP, Henri Mondor Hospital, 94000, Créteil, France. emmanuel.itti@aphp.fr.|DHU ATVB, Paris Est University, 94000, Créteil, France. emmanuel.itti@aphp.fr.|INSERM U955, GRC Amyloid Research Institute, 94000, Créteil, France. emmanuel.itti@aphp.fr.
Emmanuel
E
Itti
D000368:Aged; D000369:Aged, 80 and over; D028227:Amyloid Neuropathies, Familial / Q000000981:diagnostic imaging*; D001706:Biopsy; D004164:Diphosphonates / Q000493:pharmacokinetics*; D005060:Europe; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D009206:Myocardium / Q000378:metabolism; D015609:Organotechnetium Compounds / Q000493:pharmacokinetics*; D011877:Radionuclide Imaging; D012044:Regression Analysis; D013669:Technetium Tc 99m Medronate / Q000031:analogs & derivatives* / Q000493:pharmacokinetics
D004164:Diphosphonates; D015609:Organotechnetium Compounds; C033905:technetium Tc 99m 1,1-diphosphonopropane-2,3-dicarboxylic acid; C024226:technetium Tc 99m hydroxymethylene diphosphonate; D013669:Technetium Tc 99m Medronate
99mTc-DPD; 99mTc-HMDP; Transthyretin-related cardiac amyloidosis; early phase; myocardial uptake