Discordant Findings on 18F-NaF and 99mTc-HDP Bone Scans in a Patient With ATTR Cardiac Amyloidosis

Clin Nucl Med. 2018 Mar;43(3):e89-e92. doi: 10.1097/RLU.0000000000001933.

Abstract

Cardiac amyloidosis is an important cause of restrictive cardiomyopathy and congestive heart failure. Bone scintigraphy with [Tc]hydroxymethylene diphosphonate (Tc-HDP) and [F]sodium fluoride (F-NaF) have been investigated in the noninvasive diagnosis of transthyretin (ATTR)-related cardiac amyloidosis. We present a case of a 76-year-old man with metastatic prostate cancer who underwent Tc-HDP bone scintigraphy with an incidental finding of diffuse left ventricular abnormal uptake suggesting ATTR cardiac amyloidosis. Review of previous imaging showed a negative F-NaF PET/CT study. This example suggests that the mechanism of uptake of Tc-HDP and F-NaF may differ in patients with ATTR cardiac amyloidosis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amyloidosis / diagnostic imaging*
  • Amyloidosis / metabolism
  • Bone and Bones / diagnostic imaging*
  • Diphosphonates*
  • Fluorine Radioisotopes*
  • Humans
  • Male
  • Organotechnetium Compounds*
  • Positron Emission Tomography Computed Tomography*
  • Prealbumin / metabolism*
  • Sodium Fluoride*

Substances

  • Diphosphonates
  • Fluorine Radioisotopes
  • Organotechnetium Compounds
  • Prealbumin
  • technetium Tc 99m hydroxydiphosphonate
  • Sodium Fluoride
  • Fluorine-18