99mTc-DPD scintigraphy in transthyretin-related familial amyloidotic polyneuropathy

• Published in: European journal of nuclear medicine and molecular imaging Vol. 29; no. 3; pp. 376 - 379
• Main Authors: Puille, Max, Altland, Klaus, Linke, Reinhold P, Steen-Müller, Mary K, Kiett, Rigobert, Steiner, Dagmar, Bauer, Richard
• Format: Journal Article
• Language: English
• Published: Germany Springer Nature B.V 01-03-2002
• Subjects: Adult; Aged; Amyloid Neuropathies, Familial - diagnostic imaging; Amyloid Neuropathies, Familial - metabolism; Amyloid Neuropathies, Familial - pathology; Biopsy; Diphosphonates - pharmacokinetics; Female; Heart - diagnostic imaging; Humans; Male; Middle Aged; Organotechnetium Compounds - pharmacokinetics; Radionuclide Imaging; Radiopharmaceuticals - pharmacokinetics; Whole-Body Counting
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-001-0730-0

Familial amyloidotic polyneuropathy (FAP) caused by amyloidogenic transthyretin (ATTR) mutations is the most common form of hereditary amyloidosis. We investigated the diagnostic value of the bone scanning agent technetium-99m 3,3-diphosphono-1,2-propanodicarboxylic acid (99mTc-DPD) in this disease. Eight patients (four males, four females; age 54.4+/-8.3 years, range 43-67 years) with ATTR-FAP proven by immunohistochemistry and molecular analysis and a control group comprising ten oncological out-patients (five males, five females; age 53.4+/-8.5 years, range 34-66 years) without evidence of bony metastases were studied using 99mTc-DPD. Whole body tracer retention was 80.1%+/-10.3% (range 65.1%-94.8%) in FAP patients and 55.7%+/-8.1% (range 40.2%-66.7%) in controls at 3 h p.i. (P<0.001), and cardiac uptake was 7.3%+/-2.2% (range 4.2%-10.1%) in FAP patients and 3.1%+/-0.5% (range 2.3%-4.0%) in controls (P<0.001). The heart/whole body uptake ratio was 8.9%+/-1.7% (range 6.5%-11.0%) in FAP patients and 5.6%+/-0.5% (range 5.1%-6.8%) in controls (P<0.001). The three FAP patients with the highest cardiac tracer uptake had cardiomyopathy or arrhythmia. 99mTc-DPD scintigraphy is proposed as a simple and valuable diagnostic aid to evaluate the severity of the disease and the risk of concomitant heart problems.