Diagnostic value of bone scintigraphy versus cardiovascular magnetic resonance in cardiac amyloidosis

• DOI: 10.1016/j.jocmr.2025.101859
• Publication Date: 2025-02-12T17:10:03Z
• Authors: Josefin Obergassel; Michael Bietenbeck; Nuriye Akyol; Volker Vehof; Claudia Meier; Maria Theofanidou; Philipp Stalling; Ali Yilmaz
• Keywords: Angiology; Bone scintigraphy; Cardiac Amyloidosis; Value (mathematics)

Accurate diagnosis of transthyretin amyloidosis cardiomyopathy (ATTR-CM) and its differentiation from light-chain (AL) cardiac (CA) cases (AL-CM) is paramount importance, since treatment strategies are totally different obviously more successful in case early disease detection. Surprisingly, comparative imaging data based on concurrent cardiovascular magnetic resonance (CMR) bone scintigraphy the same patients with biopsy-proven CA still rare. This was a real-world retrospective single-centre study local clinical care pipeline we carefully analysed clinical, laboratory, CMR, (and if necessary additional endomyocardial biopsy (EMB) data) suspected CA. As major inclusion criterion, only looked at those who underwent both CMR - clear-cut finding detected by least one method. N=123 whom final obtained either non-invasively combined findings monoclonal protein studies or invasively EMB were included. A positive result indicating presence found 121 suggesting sensitivity 98.4% for any Bone identified 18 low to moderate uptake (Perugini-score = 0-1) 105 high ≥2) resulting 85.4% There an agreement ("diagnostic match") between results 103 (84%) total cohort, while discrepancy mismatch") observed 20 (16%). In out these diagnostic mismatch cases, correctly diagnosed despite negative inconclusive (eight AL-CM, eight ATTR-CM, two EMB-proven but unspecified CA). shows substantially higher yield compared scintigraphy, cohort comprising subtypes at, does not detect ATTR-CM also depicts other such as AL. unequivocally indicative CA, there no incremental value additionally performed scintigraphy. No financial support influence pharmaceutical company.