Martin Emily, Kassira Anne, Stuckey Alan, Whittle Bryan, Guthrie Spencer, Kennel Stephen J, Wall Jonathan S
Department of Medicine, University of Tennessee Graduate School of Medicine, Knoxville, TN, USA.
University Cardiology, University of Tennessee Graduate School of Medicine, Knoxville, TN, USA.
J Nucl Cardiol. 2025 Jul 29:102451. doi: 10.1016/j.nuclcard.2025.102451.
Systemic amyloidosis is a complex disorder, making early and accurate diagnosis challenging. The most common types are associated with misfolded transthyretin or immunoglobulin light chains, where cardiac and renal amyloidosis portend the worst prognosis. Peptide p5+14 can bind all types of amyloid via multivalent electrostatic interactions. When radiolabeled with either iodine-124 or technetium-99m, it can be used to detect cardiac and extracardiac amyloid deposits using PET/CT or SPECT/CT imaging, respectively. I-p5+14 (I-evuzamitide) has been evaluated in eight investigator-initiated studies and is now in a pivotal Phase 3 study (REVEAL) for the detection of cardiac amyloidosis. Both radiotracers image cardiac ATTR and AL amyloid; however, due to the characteristics of the radionuclides, the images and image data are similar but uniquely different and complementary. Using data collected from the University of Tennessee Medical Center experiences, herein, we summarize and contrast characteristics of I-evuzamitide and Tc-p5+14 as radiotracers for amyloid detection.
系统性淀粉样变性是一种复杂的疾病，早期准确诊断具有挑战性。最常见的类型与错误折叠的转甲状腺素蛋白或免疫球蛋白轻链有关，其中心脏和肾脏淀粉样变性预后最差。肽p5 + 14可通过多价静电相互作用结合所有类型的淀粉样蛋白。用碘 - 124或锝 - 99m进行放射性标记后，它可分别用于通过PET/CT或SPECT/CT成像检测心脏和心脏外淀粉样沉积物。I - p5 + 14（I - 依伏扎米肽）已在八项由研究者发起的研究中进行了评估，目前正处于用于检测心脏淀粉样变性的关键3期研究（REVEAL）中。两种放射性示踪剂均可对心脏ATTR和AL淀粉样蛋白成像；然而，由于放射性核素的特性，图像和图像数据相似但又独特不同且相互补充。利用从田纳西大学医学中心的经验中收集的数据，在此我们总结并对比了I - 依伏扎米肽和Tc - p5 + 14作为淀粉样蛋白检测放射性示踪剂的特征。
