Heart failure & cardiomyopathiesResearch article
18F-Florbetaben Positron Emission Tomography (PET) Detection of Cardiac and Multi-Organ Involvement for Identifying AL and ATTR Cardiac Amyloidosis
- Multicentric study
Authors' conclusion
Whole-body 18F-florbetaben PET identifies CA and differentiates AL-CA from ATTR-CA. These distinctions are strengthened by combining assessments of cardiac and multi-organ involvement.
Study context
- Population
- Patients with left ventricular hypertrophy due to AL-CA, ATTR-CA, or aortic stenosisAL-CA 25 · ATTR-CA 25 · aortic stenosis (controls) 11
- Participants
- 61 patients
- Comparison
- Whole-body 18F-florbetaben PET to identify cardiac amyloidosis (CA) and differentiate AL-CA from ATTR-CA
- AL-CAn = 25
- ATTR-CAn = 25
- Aortic stenosis (controls)n = 11
Main finding
As reported in the abstract
Whole-body PET tracer uptake
- Tracer uptake significantly increased in CA patients compared to controls
- AL-CA: increased uptake in myocardium, lung, and spleen; decreased uptake in blood, salivary glands, skeletal muscle, and liver
Further findings
Myocardial/blood SUVmax ratio for differentiating AL-CA from ATTR-CA
- Patients identified correctly
- 90% (55/61)
- kappa value
- 0.819
- SUVmax ratio thresholds
- 2-to-4 for ATTR-CA and >4 for AL-CA
Combined cardiac and extracardiac PET variables (myocardial uptake volume, lung/salivary gland SUVmean)
- Patients identified correctly
- 93% (57/61)
- kappa value
- 0.871
- Thresholds
- myocardial uptake volume >10 mL for CA and lung/salivary gland SUVmean >0.285 for AL-CA
Improvement over bone scan Perugini score
- PET variables improved the overall prediction provided by the bone scan Perugini score
- P < 0.001
Original publication
18F-Florbetaben PET Detection of Cardiac and Multi-Organ Involvement for Identifying AL and ATTR Cardiac Amyloidosis. JACC Adv. doi:10.1016/j.jacadv.2026.102626
Summarised from the published abstract; every number is checked against it