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Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) Cardiac scintigraphy with 99mTc-diphosphonates in cardiac amyloidosis
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Vol. 39. Issue 4.
Pages 254-266 (July - August 2020)
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Vol. 39. Issue 4.
Pages 254-266 (July - August 2020)
Continuing Education
DOI: 10.1016/j.remnie.2020.06.006
Cardiac scintigraphy with 99mTc-diphosphonates in cardiac amyloidosis
Gammagrafía cardíaca con 99mTc-difosfonatos en la amiloidosis cardíaca
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F.J. de Haro-del Morala,f,
Corresponding author
, V. Pubul-Núñezb,f, I. Casáns-Tormoc,f, A. Jiménez-Heffernand,f, R. Ruano-Péreze,f
a Servicio de Medicina Nuclear, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
b Servicio de Medicina Nuclear, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, Spain
c Servicio de Medicina Nuclear, Hospital Clínico Universitario de Valencia, Valencia, Spain
d Servicio de Medicina Nuclear, Hospital Universitario Juan Ramón Jiménez, Huelva, Spain
e Servicio de Medicina Nuclear, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
f Grupo de Trabajo de Cardiología Nuclear de la Sociedad Española de Medicina Nuclear e Imagen Molecular (SEMNIM), Spain
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Tables (2)
Table 1. Subtypes of amyloidosis affecting the heart.
Table 2. Situations of consensus in which cardiac scintigraphy with diphosphonates must be performed within the context of cardiac amyloidosis.
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Abstract

Transthyretin cardiac amyloidosis (ATTR) has traditionally been considered a rare, difficult-to-diagnose and untreatable disease. However, its prevalence is known to be greater than what was previously thought, non-invasive diagnostic methods are available, and that effective treatments are emerging. In this context, cardiac scintigraphy (CS) with 99mTc-labeled diphosphonates has aroused a noticeable surge in interest by demonstrating high sensitivity and specificity for the reliable, non-invasive diagnosis of ATTR. By way of a guide, this article aims to identify the critical components in the performance of CS that are useful in everyday clinical practice and, thus, help specialists use optimal radiopharmaceuticals, obtain the most appropriate images, interpret the results thereof, and acquaint themselves with those clinical scenarios in which it is convenient to perform CS.

Keywords:
Cardiac amyloidosis
ATTR
99mTc-diphosphonates
Scintigraphy
Resumen

La amiloidosis cardíaca relacionada con el depósito de transtirretina (ATTR) ha sido tradicionalmente considerada como una enfermedad rara, de difícil diagnóstico y sin tratamiento. Sin embargo, en la actualidad sabemos que su prevalencia es mayor de la considerada, disponemos de métodos diagnósticos no invasivos y están apareciendo tratamientos eficaces. En este contexto, la gammagrafía cardíaca (GC) con difosfonatos marcados con 99mTc ha alcanzado un inusitado interés al mostrar alta sensibilidad y especificidad para el diagnóstico no invasivo y fiable de la ATTR. Este artículo, a modo de guía, pretende identificar los componentes críticos en la realización de la GC que resulten de utilidad en la práctica clínica diaria y, así, ayudar a los especialistas a utilizar los radiofármacos idóneos, obtener las imágenes más adecuadas, interpretar los resultados de estas y conocer los escenarios clínicos en los que resulta apropiado realizar la GC.

Palabras clave:
Amiloidosis cardíaca
ATTR
99mTc-difosfonatos
Gammagrafía

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