Technetium-99m (Tc-99m) diphosphono-propanedicarboxylic acid bone tracer uptake and Tc-99m sestamibi distribution in cardiac amyloidosis--a case report

• Published in: Annals of the Academy of Medicine, Singapore Vol. 24; no. 6; pp. 898 - 901
• Main Authors: Low, Y H, Ang, E S, Goh, A S, Sundram, F X, Sin, F L
• Format: Journal Article
• Language: English
• Published: Singapore 01.11.1995
• Subjects: Amyloid Neuropathies - diagnosis; Amyloid Neuropathies - pathology; Amyloidosis - diagnostic imaging; Amyloidosis - pathology; Cardiomyopathies - diagnostic imaging; Cardiomyopathies - pathology; Diphosphonates; Echocardiography; Humans; Male; Middle Aged; Myocardial Infarction - pathology; Organotechnetium Compounds; Skin - pathology; Sural Nerve - pathology; Technetium Tc 99m Sestamibi; Tissue Survival; Tomography, Emission-Computed, Single-Photon
• ISSN: 0304-4602

It has long been recognised that significant bone tracer localisation in the myocardium is a good indicator for amyloid involvement of the heart in the clinical context of systemic amyloidosis. In this case report, although myocardial tissue diagnosis of amyloidosis was not made, the massive myocardial uptake of bone tracer strongly suggested the presence of amyloid infiltration in the heart, and this finding eventually led to the histological diagnosis of familial amyloid polyneuropathy by skin and sural nerve biopsy. Interesting findings were noted in the single photon emission computerised tomography (SPECT) studies of the myocardium with Technetium-99m diphosphono-propanedicarboxylic acid bone agent and Technetium-99m sestamibi myocardial perfusion agent. Such findings suggest that there is a lack of correlation between the intensity of myocardial uptake of bone tracer and viability of the myocardium, and that amyloid will not deposit in infarcted myocardial tissue.