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Cardiac and pleuropulmonary AL amyloid imaging with technetium-99m labelled aprotinin

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Abstract

Antiproteases are known to be present in amyloid deposits. We evaluated the possibility of using an anti-serine protease (aprotinin) labelled with technetium-99m (TcA), usually employed as a cortical renal tracer, for the imaging of amyloid deposits. Because of the known high uptake of TcA by the kidneys, we limited our analysis to extra-abdominal amyloid localizations. We report the scintigraphic findings observed in 24 patients with light chain amyloidosis (AL) and one with a hereditary form who were known or suspected to have extra-abdominal involvement. Planar scans obtained 100 min after i.v. TcA administration showed myocardial accumulation in 11 patients, pleuropulmonary accumulation in nine, pericardial accumulation in two and localization in the neck region (thyroid, salivary glands and tongue) in eight. TcA scintigraphy was negative in five patients without clinical or laboratory evidence of extraabdominal involvement, as well as in 12 control group patients with cardiac and renal diseases. These preliminary results indicate TcA to be a low-cost, readily available radiopharmaceutical for imaging of extra-abdominal involvement in AL type amyloidosis.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Fondazione Clinica del Lavoro-IRCCS, Pavia, Italy

    Carlo Aprile & Raffaella Saponaro

  2. Institute of Clinical Medicine II and Research Lab. Biotechnology, Policlinico S. Matteo-IRCCS, Pavia, Italy

    Gabriella Marinone & Giampaolo Merlini

  3. SORIN Biomedica, Saluggia, VC, Italy

    Chiara Bonino

Authors
  1. Carlo Aprile
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  2. Gabriella Marinone
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  3. Raffaella Saponaro
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  4. Chiara Bonino
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  5. Giampaolo Merlini
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Aprile, C., Marinone, G., Saponaro, R. et al. Cardiac and pleuropulmonary AL amyloid imaging with technetium-99m labelled aprotinin. Eur J Nucl Med 22, 1393–1401 (1995). https://doi.org/10.1007/BF01791147

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  • DOI: https://doi.org/10.1007/BF01791147

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