Technetium-99m-pyrophosphate imaging-based computed tomography-guided core-needle biopsy of internal oblique muscle in wild-type transthyretin cardiac amyloidosis
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- Koji Takahashi
- Department of Community Emergency Medicine, Ehime University Graduate School of Medicine, Ehime, Japan
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- Yoshiyasu Hiratsuka
- Department of Radiology, Yawatahama City General Hospital, Ehime, Japan
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- Takaaki Iwamura
- Department of Radiology, Yawatahama City General Hospital, Ehime, Japan
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- Daisuke Sasaki
- Department of Radiology, Yawatahama City General Hospital, Ehime, Japan
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- Nobuhisa Yamamura
- Department of Clinical Pathology, Yawatahama City General Hospital, Ehime, Japan
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- Sohei Kitazawa
- Department of Molecular Pathology, Ehime University Graduate School of Medicine, Ehime, Japan
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- Mitsuharu Ueda
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
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- Hiroe Morioka
- Department of Cardiology, Yawatahama City General Hospital, Ehime, Japan
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- Takafumi Okura
- Department of Cardiology, Yawatahama City General Hospital, Ehime, Japan
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- Daijiro Enomoto
- Department of Cardiology, Yawatahama City General Hospital, Ehime, Japan
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- Shigeki Uemura
- Department of Cardiology, Yawatahama City General Hospital, Ehime, Japan
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- Taizo Kono
- Department of Radiology, Yawatahama City General Hospital, Ehime, Japan
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- Tomoki Sakaue
- Department of Community Emergency Medicine, Ehime University Graduate School of Medicine, Ehime, Japan
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- Shuntaro Ikeda
- Department of Community Emergency Medicine, Ehime University Graduate School of Medicine, Ehime, Japan
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説明
Technetium-99m-pyrophosphate (99mTc-PYP) uptake in the internal oblique muscle (IOM), which is often observed in patients with wild-type transthyretin cardiac amyloidosis (ATTR-CA), indicates amyloid transthyretin (ATTR) deposition. This study aimed to assess the safety and efficacy of 99mTc-PYP imaging-based computed tomography (CT)-guided core-needle biopsy of the IOM as a new extracardiac screening biopsy for confirming the presence of ATTR deposits. Patients with suspected ATTR-CA in whom myocardial tracer uptake was detected on chest- and abdomen-centered images of 99mTc-PYP scintigraphy underwent CT-guided core-needle biopsy at the site with the highest tracer uptake in the IOM between September 2021 and November 2022. All 18 consecutive patients (mean age, 86.3 years ± 6.5; 61.1% male) enrolled in the study showed 99mTc-PYP uptake into the IOM. Adequate tissue samples were obtained from all patients except one without serious complications. Immunohistochemical analysis confirmed ATTR deposits in 16/18 (88.9%) patients. In the remaining two patients, ATTR deposits were observed via endomyocardial biopsy. All patients were diagnosed with wild-type ATTR-CA based on transthyretin gene sequence testing results. In wild-type ATTR-CA, 99mTc-PYP imaging-based CT-guided core-needle biopsy of the IOM could be used as an extracardiac screening biopsy to confirm the presence of ATTR deposits.
収録刊行物
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- Amyloid
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Amyloid 31 (1), 12-21, 2023-07-24
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