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正电子发射断层扫描在转甲状腺素蛋白淀粉样心肌病患者的诊断和随访中的应用：系统综述。

Positron emission tomography in the diagnosis and follow-up of transthyretin amyloid cardiomyopathy patients: A systematic review.

机构信息

Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Hanzeplein 1, 9713GZ, Groningen, The Netherlands.

Amyloidosis Centre of Expertise, University Medical Center Groningen, Hanzeplein 1, 9713GZ, Groningen, The Netherlands.

出版信息

Eur J Nucl Med Mol Imaging. 2023 Dec;51(1):93-109. doi: 10.1007/s00259-023-06381-3. Epub 2023 Aug 10.

DOI:10.1007/s00259-023-06381-3
PMID:37561144
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10684414/
Abstract

PURPOSE

Transthyretin (ATTR) amyloidosis is a progressive protein misfolding disease with frequent cardiac involvement. This review aims to determine the value of PET in diagnosis, assessment of disease progression or treatment response and its relation to clinical outcome in follow-up of ATTR amyloid cardiomyopathy (ATTR-CM) patients.

METHODS

Medline, Cochrane Library, Embase and Web of Science databases were searched, from the earliest date available until December 2022, for studies investigating the use of PET in ATTR-CM patients. Studies containing original data were included, except for case reports. Risk of bias was assessed by QUADAS-2.

RESULTS

Twenty-one studies were included in this systematic review, investigating five different tracers: carbon-11 Pittsburgh compound B ([C]PIB), fluorine-18 Florbetaben ([F]FBB), fluorine-18 Florbetapir ([F]FBP), fluorine-18 Flutemetamol ([F]FMM) and fluorine-18 Sodium Fluoride (Na[F]F). In total 211 ATTR amyloidosis patients were included. A majority of studies concluded that [C]PIB, [F]FBP and Na[F]F can distinguish ATTR amyloidosis patients from controls, and that [C]PIB and Na[F]F, but not [F]FBP, can distinguish ATTR-CM patients from patients with cardiac light chain amyloidosis. Evidence on the performance of [F]FBB and [F]FMM was contradictory. No studies on the use of PET in follow-up were found.

CONCLUSION

[C]PIB, Na[F]F and [F]FBP can be used to diagnose cardiac amyloidosis, although [F]FBP may not be suitable for the distinction of different types of amyloid cardiomyopathy. No studies on PET in the follow-up of ATTR amyloidosis patients were found. Future research should focus on the use of these PET tracers in the follow-up of ATTR amyloidosis patients.

摘要

目的

转甲状腺素蛋白（ATTR）淀粉样变性是一种常见的伴有心脏受累的蛋白构象疾病。本综述旨在确定 PET 在诊断、疾病进展评估或治疗反应中的价值，并探讨其与 ATTR 淀粉样心肌病（ATTR-CM）患者随访中的临床结局的关系。

方法

从最早可获得的日期至 2022 年 12 月，在 Medline、Cochrane 图书馆、Embase 和 Web of Science 数据库中检索了探讨 PET 在 ATTR-CM 患者中应用的研究。纳入包含原始数据的研究，除病例报告外。使用 QUADAS-2 评估偏倚风险。

结果

本系统综述纳入了 21 项研究，涉及五种不同的示踪剂：碳-11 匹兹堡化合物 B([C]PIB)、氟-18 氟硼酸苯([F]FBB)、氟-18 氟比他滨([F]FBP)、氟-18 氟美托咪定([F]FMM)和氟-18 氟化钠(Na[F]F)。共有 211 例 ATTR 淀粉样变性患者被纳入研究。大多数研究的结论认为，[C]PIB、[F]FBP 和 Na[F]F 可以区分 ATTR 淀粉样变性患者与对照组，而 [C]PIB 和 Na[F]F 可以区分 ATTR-CM 患者与心脏轻链淀粉样变性患者，但 [F]FBP 则不能。关于 [F]FBB 和 [F]FMM 应用的证据相互矛盾。未发现关于 PET 在随访中应用的研究。

结论

[C]PIB、Na[F]F 和 [F]FBP 可用于诊断心脏淀粉样变性，尽管 [F]FBP 可能不适合区分不同类型的淀粉样心肌病。未发现关于 ATTR 淀粉样变性患者随访中使用 PET 的研究。未来的研究应集中在这些 PET 示踪剂在 ATTR 淀粉样变性患者随访中的应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a88/10684414/0d634d5904d4/259_2023_6381_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a88/10684414/7d4bde5e0642/259_2023_6381_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a88/10684414/bba56f2341ae/259_2023_6381_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a88/10684414/bc06f4dfd310/259_2023_6381_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a88/10684414/0d634d5904d4/259_2023_6381_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a88/10684414/7d4bde5e0642/259_2023_6381_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a88/10684414/bba56f2341ae/259_2023_6381_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a88/10684414/bc06f4dfd310/259_2023_6381_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a88/10684414/0d634d5904d4/259_2023_6381_Fig4_HTML.jpg

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