Author + information
- Received April 9, 2014
- Revision received September 15, 2014
- Accepted September 22, 2014
- Published online January 1, 2015.
- Seung-Pyo Lee, MD, PhD∗,†,
- Eun Seong Lee, MD‡,§,
- Hongyoon Choi, MD‡,
- Hyung-Jun Im, MD‡,
- Youngil Koh, MD†,
- Min-Ho Lee, MD∗,†,
- Ji-Hyun Kwon, MD†,
- Jin Chul Paeng, MD, PhD‡,
- Hyung-Kwan Kim, MD, PhD∗,†,
- Gi Jeong Cheon, MD, PhD‡,
- Yong-Jin Kim, MD, PhD∗,†,
- Inho Kim, MD, PhD†,
- Sung-Soo Yoon, MD, PhD†,
- Jeong-Wook Seo, MD, PhD‖ and
- Dae-Won Sohn, MD, PhD∗,†∗ ()
- ∗Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
- †Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University, Seoul, Korea
- ‡Department of Nuclear Medicine, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea
- §Department of Molecular Medicine and Biopharmaceutical Sciences, WCU Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
- ‖Department of Pathology, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea
- ↵∗Reprint requests and correspondence:
Dr. Dae-Won Sohn, Cardiovascular Center, Seoul National University Hospital and Department of Internal Medicine, Seoul National University College of Medicine, Seoul 110-744, Korea.
Objectives This study sought to investigate the efficacy of 11C-Pittsburgh B (PiB) positron emission tomography (PET)/computed tomography (CT) in the diagnosis of cardiac amyloidosis.
Background The PiB compound has been promising for detection of amyloid deposits in the brain.
Methods A total of 22 consecutive patients were enrolled in this prospective pilot study of monoclonal gammopathy patients with suspected cardiac amyloidosis. The study consisted of a series of 11C-PiB PET/CT, echocardiography, cardiac magnetic resonance, and endomyocardial biopsy within a 1-month period. In addition, 10 normal subjects were recruited to determine the most optimal cut-off value for a positive 11C-PiB PET/CT scan.
Results Among the 22 patients, 15 patients were diagnosed as cardiac amyloidosis by endomyocardial biopsy and 5 patients had undergone chemotherapy previously before the 11C-PiB PET/CT. There were no differences in echocardiographic parameters between patients with versus without cardiac amyloidosis, except for a marginal difference in the left ventricular end-diastolic dimension (median 41.0 mm [range 33.0 to 49.0 mm] vs. 50.0 mm [range 38.0 to 55.0 mm], p = 0.066). 11C-PiB PET/CT was positive in 13 of 15 biopsy-proven cardiac amyloidosis patients, whereas none of the patients without cardiac amyloidosis demonstrated positive 11C-PiB PET/CT scan results. The maximal myocardium-to-blood cavity ratio was significantly different between patients with versus without cardiac amyloidosis (median 3.9 [range 1.7 to 19.9] vs. 1.0 [range 0.8 to 1.2], p < 0.001). In association with the significant difference of 11C-PiB uptake in the myocardium between the chemotherapy naïve versus the previous chemotherapy group (median 10.4 [range 1.7 to 19.9] vs. 2.3 [range 1.7 to 3.8], p = 0.014), all except 1 patient among the 5 previously treated patients had responded to chemotherapy by serum free light chain assay results at the time of 11C-PiB PET/CT scan.
Conclusions 11C-PiB PET/CT may be valuable for the diagnosis of cardiac amyloidosis noninvasively. Whether 11C-PiB PET/CT may be a good surrogate marker of active light chain deposition in the myocardium warrants further investigation in a larger number of patients.
- cardiac amyloidosis
- cardiac magnetic resonance
- Pittsburgh B compound
- positron emission tomography
This study was supported by a grant from the Korean Health Technology R&D Project funded by the Ministry of Health, Welfare & Family Affairs (A120753). All authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received April 9, 2014.
- Revision received September 15, 2014.
- Accepted September 22, 2014.
- 2015 American College of Cardiology Foundation