Cardiac Amyloid Imaging with ¹⁸F-Florbetaben PET: A Pilot Study

¹⁸F-florbetaben PET (left column in each panel), low-dose CT (middle column), and PET/CT images (right column) of representative AL patient (A), ATTR patient (B), and hypertensive control (C). There was diffuse avid ¹⁸F-florbetaben myocardial uptake in both AL and ATTR patients but little radiotracer uptake in myocardium of hypertensive control. PET images were windowed to display myocardial boundaries.

¹⁸F-florbetaben time–activity curves in AL patients (A), ATTR patients (B), and controls (C). Data points are mean SUVs in LV myocardium and blood-pool peak at 2−3 min after radiotracer injection; error bars represent SDs. Target-to-background ratios were significantly higher in AL and ATTR patients than in hypertensive controls after the initial 10 min and persisted until end of image acquisition. There was a trend toward higher myocardial SUV in AL than ATTR patients. There was also greater variability in myocardial SUV in AL than ATTR patients.

¹⁸F-florbetaben RI over time in AL patients, ATTR patients, and controls. Mean myocardial retention of ¹⁸F-florbetaben was higher in both AL and ATTR patients than in controls. Error bars represent ranges.

Box plots for myocardial ¹⁸F-florbetaben RI in AL patients, ATTR patients, and controls. Myocardial ¹⁸F-florbetaben RI was significantly higher in AL and ATTR patients. All cardiac amyloid patients and no hypertensive controls had myocardial ¹⁸F-florbetaben RI greater than 0.020 min⁻¹.

Box plots for percentage myocardial ¹⁸F-florbetaben retention for AL patients, ATTR patients, and controls. Percentage myocardial ¹⁸F-florbetaben retention was significantly higher in AL and ATTR patients. All cardiac amyloid patients and no hypertensive controls had myocardial retention greater than 40%.