Okuyama Chio, Inuzuka Yasutaka, Takeuchi Yuzo, Asagoe Kohsuke, Kagawa Shinya, Ito Miki, Kusano Kuninori, Fujita Yoshiharu, Watanabe Hiroyuki, Ono Masahiro, Higashi Tatsuya
Clinical Research Center, Shiga General Hospital, 5-4-30, Moriyama-Cho, Moriyama, Shiga, 524-8524, Japan.
Department of Cardiology, Shiga General Hospital, Moriyama, Japan.
Ann Nucl Med. 2025 Apr;39(4):398-403. doi: 10.1007/s12149-024-02010-7. Epub 2024 Dec 20.
This study aimed to evaluate the diagnostic ability of 5-(5-(2-(2-(2-F-fluoroethoxy) ethoxy) ethoxy) benzofuran-2-yl)-N-methylpyridin-2-amine (F-FPYBF-2) dynamic PET for patients with cardiac amyloidosis (CA).
The subjects were patients diagnosed with proven amyloidosis (n = 16) including transthyretin cardiac amyloidosis (ATTR-CA) (n = 7) and light chain amyloidosis (AL amyloidosis) (n = 9), of which 4 and 5 with (AL-CA) and without (AL-nCA) cardiac involvement, and 4 control subjects suffering from some symptoms of cardiac failure without amyloidosis (CTL). Thirty minutes dynamic F-FPYBF-2 PET/CT was performed to evaluate the time activity curve and the retention index (mRI) as the ratio of the myocardial SUV at 15 to 5 min. The results of bone scan were also evaluated except for 2 AL-nCA cases.
Diffuse F-FPYBF-2 distribution in the myocardium was observed within a few minutes in all cases. The accumulation was still seen at 30 min after injection in all the CA cases, while it showed rapid clearance in CTL and AL-nCA cases. The values mRI of the ATTR-CA and AL-CA were significantly higher than CTL and AL-nCA cases, and AL-CA showed higher value than ATTR-CA (p < 0.05), while the positive results of bone scan were observed in all ATTR-CA cases, and in one case of AL-CA.
F-FPYBF-2 PET could be a useful tool to evaluate cardiac involvement of amyloidosis and can visualize AL-CA regardless of the results of bone scan.
本研究旨在评估5-(5-(2-(2-(2-氟乙氧基)乙氧基)乙氧基)苯并呋喃-2-基)-N-甲基吡啶-2-胺（F-FPYBF-2）动态PET对心脏淀粉样变性（CA）患者的诊断能力。
研究对象为确诊为淀粉样变性的患者（n = 16），包括转甲状腺素蛋白心脏淀粉样变性（ATTR-CA）（n = 7）和轻链淀粉样变性（AL淀粉样变性）（n = 9），其中4例和5例分别有（AL-CA）和无（AL-nCA）心脏受累，以及4例患有心力衰竭但无淀粉样变性症状的对照受试者（CTL）。进行30分钟的动态F-FPYBF-2 PET/CT检查，以评估时间-活性曲线和保留指数（mRI），即15分钟与5分钟时心肌SUV的比值。除2例AL-nCA病例外，还评估了骨扫描结果。
在所有病例中，数分钟内即可观察到心肌内F-FPYBF-2的弥漫性分布。所有CA病例在注射后30分钟仍可见放射性聚集，而CTL和AL-nCA病例则显示放射性快速清除。ATTR-CA和AL-CA病例的mRI值显著高于CTL和AL-nCA病例，且AL-CA病例的值高于ATTR-CA病例（p < 0.05），而所有ATTR-CA病例和1例AL-CA病例的骨扫描结果为阳性。
F-FPYBF-2 PET可能是评估淀粉样变性心脏受累的有用工具，并且无论骨扫描结果如何，都可以显示AL-CA。
