Targeted Nuclear Imaging Probes for Cardiac Amyloidosis

Abstract

Purpose of Review: The aim of the present manuscript is to review the latest advancements of radionuclide molecular imaging in the diagnosis and prognosis of individuals with cardiac amyloidosis. Recent Findings: 99mTechnetium labeled bone tracer scintigraphy had been known to image cardiac amyloidosis, since the 1980s; over the past decade, bone scintigraphy has been revived specifically to diagnose transthyretin cardiac amyloidosis. 18F labeled and 11C labeled amyloid binding radiotracers developed for imaging Alzheimer’s disease, have been repurposed since 2013, to image light chain and transthyretin cardiac amyloidosis. Summary: 99mTechnetium bone scintigraphy for transthyretin cardiac amyloidosis, and amyloid binding targeted PET imaging for light chain and transthyretin cardiac amyloidosis, are emerging as highly accurate methods. Targeted radionuclide imaging may soon replace endomyocardial biopsy in the evaluation of patients with suspected cardiac amyloidosis. Further research is warranted on the role of targeted imaging to quantify cardiac amyloidosis and to guide therapy.