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99m Technetium-pyrophosphate bone scan: a potential biomarker for the burden of transthyretin amyloidosis in skeletal muscle: a preliminary study
Muscle Nerve. 2022 Oct 12. doi: 10.1002/mus.27740.
Richard Wlodarski 1, Kaitlin Seibert 1, Naoum P Issa 1, Bill O'Brien-Penney 2, Betty Soliven 1, Nitasha Sarswat 3, Daniel Appelbaum 2, Kourosh Rezania 1
Abstract:
Introduction / aim: Transthyretin amyloidosis (ATTR) proteins can infiltrate skeletal muscle and infrequently cause a myopathy. 99mTechnetium-pyrophosphate (99m Tc-PYP) is a validated biomarker for cardiac involvement in variant and wild type ATTR (ATTRv and ATTRwt). The aim of this study was to test the hypothesis that 99m Tc-PYP is a biomarker for muscle burden of ATTR.
Methods: Radioisotope uptake in the deltoid muscles of patients with ATTR was compared to uptake in control subjects without amyloidosis in a retrospective study. 99m Tc-PYP scans were evaluated in 11 patients with ATTR (7 ATTRv, 4 ATTRwt) and 14 control subjects. Mean count (MC) values were measured in circular regions of interest (ROI) 2.5-3.8 cm2 in area. Tracer uptake was quantified in the heart, contralateral chest (CC) and deltoid muscles.
Results: Tracer uptake was significantly higher over the deltoids and heart but not the CC, in patients with ATTR than in control subjects. MC values were 120.1 +/- 43.7 (mean ± SD) in ATTR patients and 78.9+/-20.4 in control subjects over the heart (P= 0.005), 73.3 +/- 21.0 and 63.5+/-14.4 over CC (P= 0.09), and 37.0 +/- 11.7 and 26.0+/- 7.1 averaged over both deltoid muscles (P= 0.014).
Discussion: 99m Tc-PYP is a potential biomarker for ATTR amyloid burden in skeletal muscle.
Methods: Radioisotope uptake in the deltoid muscles of patients with ATTR was compared to uptake in control subjects without amyloidosis in a retrospective study. 99m Tc-PYP scans were evaluated in 11 patients with ATTR (7 ATTRv, 4 ATTRwt) and 14 control subjects. Mean count (MC) values were measured in circular regions of interest (ROI) 2.5-3.8 cm2 in area. Tracer uptake was quantified in the heart, contralateral chest (CC) and deltoid muscles.
Results: Tracer uptake was significantly higher over the deltoids and heart but not the CC, in patients with ATTR than in control subjects. MC values were 120.1 +/- 43.7 (mean ± SD) in ATTR patients and 78.9+/-20.4 in control subjects over the heart (P= 0.005), 73.3 +/- 21.0 and 63.5+/-14.4 over CC (P= 0.09), and 37.0 +/- 11.7 and 26.0+/- 7.1 averaged over both deltoid muscles (P= 0.014).
Discussion: 99m Tc-PYP is a potential biomarker for ATTR amyloid burden in skeletal muscle.
PMID: 36222831
Tags: 99m technetium, ATTR, biomarkers, humans, methods, muscle, Transthyretin amyloidosis