Heart Failure in Cardiac Amyloidosis: Suspecting and Diagnosing Transthyretin Amyloid Cardiomyopathy in Underdiagnosed Populations at Risk for Heart Failure-Interpretation and Reporting Template

Interpretation and Reporting Template

Pdf Summary

Cardiac scintigraphy with bone-avid tracers, like Tc-99m DPD, PYP, and HDP, is crucial in confirming ATTR-CA. Recent guidelines stress the use of tomographic imaging over planar imaging for accurate diagnosis. Tracer uptake should be assessed on SPECT imaging, with imaging at 1 or 3 hours post-injection both showing diagnostic accuracy. Light chain amyloidosis must be considered, recommending plasma cell dyscrasia assessment alongside imaging findings. A semi-quantitative Perugini Score can aid in diagnosis, with Grade 2 or 3 uptake indicating ATTR-CA. Quantitation of tracer uptake can provide additional disease status information. False interpretations, especially from planar imaging, should be avoided, necessitating a thorough reporting approach. Varying patient cases demonstrate the importance of comprehensive and accurate interpretation and reporting in suspected cases of ATTR-CA. Standardized reporting should include demographic details, methods, findings, ancillary results, and clear conclusions. To avoid misdiagnosis, exclusion of monoclonal proteins is crucial. Overall, thorough imaging interpretation and reporting are essential in guiding accurate diagnosis and appropriate management of individuals suspected of having ATTR-CA.

Keywords

Cardiac scintigraphy

Bone-avid tracers

Tc-99m DPD

Tc-99m PYP

Tc-99m HDP

ATTR-CA

SPECT imaging

Perugini Score

Plasma cell dyscrasia

Monoclonal proteins