Significance Of C-11-Pib Pet/Ct In Cardiac Amyloidosis Compared With Tc-99m-Aprotinin Scintigraphy: A Pilot Study

Background This study was to investigate the significance of C-11-Pittsburgh B (PIB) PET/CT in patients with suspected cardiac amyloidosis compared with Tc-99m-aprotinin scintigraphy. Methods Thirteen consecutive patients with suspected cardiac amyloidosis were considered for enrolment in this prospective pilot study. Participants were scheduled to undergo a series of C-11-PIB PET/CT and Tc-99m-aprotinin within a 2-month period. Finally, we evaluated nine cases who underwent both imaging modalities, and compared imaging results with clinical and pathological results and prognosis. Results Six of the 9 patients who underwent both imaging modalities were diagnosed with amyloidosis, of whom 3 patients were diagnosed with cardiac amyloidosis from endomyocardial biopsy. These 3 patients with positive C-11-PIB uptake at the left ventricle wall showed worsening of cardiac function progressing in the short term or death caused by acute exacerbation of chronic heart failure. Six of 8 patients with positive uptake on Tc-99m-aprotinin presented with amyloid deposition in the left ventricle wall, but symptoms remained stable if results of C-11-PIB were not positive. Conclusion In a small sample of subjects, the present study showed that C-11-PIB accumulation in myocardium indicated cardiac amyloidosis with poor prognosis. Uptake of C-11-PIB may be related to progressive amyloid deposition to the heart and can predict patient prognosis.