[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-496706-105":59,"doc-detail-496706-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","cardiac-amyloidosis-asnc-practice-points-99mtechnetium-pyrophosphate-imaging-for-transthyretin-cardiac-amyloidosis","CARDIAC AMYLOIDOSIS ASNC PRACTICE POINTS - 99mTechnetium-Pyrophosphate Imaging for Transthyretin Cardiac Amyloidosis","","Purpose of this ASNC practice points document is to identify critical components for performing 99mTechnetium-pyrophosphate (99mTc-PYP) imaging to evaluate cardiac transthyretin (ATTR) amyloidosis. It reviews the clinical background of cardiac amyloidosis, outlines patient selection criteria, and describes tracer procurement, including kit contents and estimated effective dose. It then presents practical test preparation and standardized imaging procedure recommendations, including when planar imaging or SPECT/SPECT-CT and whole-body adjunct imaging are useful for interpretation and quantification.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/cardiac-amyloidosis-asnc-practice-points-99mtechnetium-pyrophosphate-imaging-for-transthyretin-cardiac-amyloidosis/496706/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/cardiac-amyloidosis-asnc-practice-points-99mtechnetium-pyrophosphate-imaging-for-transthyretin-cardiac-amyloidosis/496706.png","ImageObject",300,407,{"name":92,"@type":93},"Aditya","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-10","2026-10-02",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What is the goal of 99mTc-PYP imaging in suspected cardiac ATTR amyloidosis?","Question",{"text":113,"@type":114},"It enables non-invasive identification of ATTR cardiac amyloidosis and supports patient management by guiding diagnosis and differentiation from AL amyloidosis when appropriate.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"Who should be considered for 99mTc-PYP imaging?",{"text":118,"@type":114},"Individuals with heart failure plus unexplained increased left ventricular wall thickness, older African-American patients with heart failure and thickened ventricles, those with preserved ejection fraction and unexplained heart failure, and patients with compatible findings on CMR/echocardiography or certain clinical syndromes without typical risk factors.",{"name":120,"@type":111,"acceptedAnswer":121},"What imaging approaches are recommended and how are they used?",{"text":122,"@type":114},"Planar imaging supports visual interpretation and quantification via heart-to-lung ratio or rib uptake comparison, while 1-hour planar-only without SPECT is not recommended. SPECT (or SPECT/CT when available) can help separate blood pool from myocardial activity, evaluate distribution of uptake, assess the interventricular septum, and quantify uptake; whole-body planar imaging may be an optional adjunct to detect systemic involvement.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},496706,1791038237,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":36,"preview_page_count":4},962085564549,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","ASNC  \nCARDIAC AMYLOIDOSIS PRACTICE POINTS UPDATE  \n99mTechnetiumPyrophosphate Imaging for Transthyretin Cardiac Amyloidosis  \nCopyright © 2021 American Society of Nuclear Cardiology  \nCARDIAC AMYLOIDOSIS ASNC PRACTICE POINTS  \n99mTechnetium-Pyrophosphate Imaging for Transthyretin Cardiac Amyloidosis  \nOVERVIEW  \nThe purpose of this document is to identify the critical components involved in performing 99mTechnetium-pyrophosphate (99mTc-PYP) imaging for the evaluation of cardiac transthyretin amyloidosis (ATTR) .  \nBACKGROUND  \n• The majority of individuals with cardiac amyloidosis have myocardial amyloid deposits formed from misfolded light chain (AL) or transthyretin (TTR) proteins. Diagnosis of amyloidosis and differentiation between the types is important for prognosis, therapy, and genetic counseling.  \n• Cardiac ATTR amyloidosis, the focus of this practice points document, isan under diagnosed cause of heart failure.  \n• Amyloid derived from wild-type TTR results in a restrictive cardiomyopathy, most commonly presenting in men in their early 70s onwards, but occasionally seen as young as age 60. Although almost  \n1 in 4 males > 80 years have some TTR-derived amyloid deposits at autopsy, the clinical significance of a mild degree of deposition is unknown--generally clinical manifestations of heart failure occur once enough amyloid has been deposited to cause LV wall thickening (1) .  \n• Approximately 3 – 4% among US African Americans have a common inherited mutation of the TTR gene (Val122Ile), which produces a restrictive cardiomyopathy in a minority, but may contribute to heart failure in a higher proportion (1) .  \n• Cardiac amyloidosis should be suspected in individuals with heart failure and thickened ventricles with grade 2 or greater diastolic dysfunction on echocardiography or typical findings on cardiac magnetic resonance imaging (CMR; diffuse late gadolinium enhancement, ECV expansion or characteristic T-1 relaxation times); diagnosis is confirmed by endomyocardial biopsy and typing of amyloid fibrils as needed.  \n• Several studies confirm the high sensitivity and specificity of 99mTc-bone compound scintigraphy [99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD) or PYP (2, 3] for cardiac ATTR  \nCARDIAC AMYLOIDOSIS ASNC PRACTICE POINTS 1  \namyloidosis; recent studies highlight the value of DPD and/or PYP in differentiating cardiac ATTR from AL amyloidosis (4) .  \n• A distinct advantage of 99mTc-PYP imaging, even when echocardiography and CMR are diagnostic for cardiac amyloidoisis, is its ability to specifically identify ATTR cardiac amyloidosis non-invasively and thereby guide patient management (5) .  \nPATIENT SELECTION  \n• Individuals with heart failure and unexplained increase in left ventricular wall thickness.  \n• African-Americans over the age of 60 years with heart failure, unexplained or with increased left ventricular wall thickness (>12 mm) .  \n• Individuals over the age of 60 years with unexplained heart failure with preserved ejection fraction.  \n• Individuals, especially elderly males, with unexplained neuropathy, bilateral carpal tunnel syndrome or atrial arrhythmias in the absence of usual risk factors, and signs/symptoms of heart failure.  \n• Evaluation of cardiac involvement in individuals with known or suspected familial amyloidosis.  \n• Diagnosis of cardiac ATTR amyloidosis in individuals with CMR or echocardiography consistent with cardiac amyloidosis.  \n• Patients with suspected cardiac ATTR amyloidosis and contraindications to CMR such as renal insufficiency or an implantable cardiac device (5) .  \nOBTAINING THE RADIOTRACER  \n• 99mTc-PYP is readily available as unit doses from commercial radiopharmaceutical distributors or as kits for preparation.  \n• Kits containing 5 or 30 single-use vials are commercially available. Each 10 ml vial contains 11.9 mg of sodium pyrophosphate and 3.2 mg of stannous chloride and 4.4 mg of total tin, and this kit is approved for bone, cardiac (for the de","cbCainl4m8IRnHlS","https://ap.wps.com/l/cbCainl4m8IRnHlS","pdf",1103269,16,"English","# Overview\n# Background\n# Patient Selection\n# Obtaining the Radiotracer\n# Test Preparation\n# Imaging Procedure\n## Planar Imaging\n## SPECT/SPECT-CT and Optional Whole-Body Imaging","[{\"question\":\"What is the goal of 99mTc-PYP imaging in suspected cardiac ATTR amyloidosis?\",\"answer\":\"It enables non-invasive identification of ATTR cardiac amyloidosis and supports patient management by guiding diagnosis and differentiation from AL amyloidosis when appropriate.\"},{\"question\":\"Who should be considered for 99mTc-PYP imaging?\",\"answer\":\"Individuals with heart failure plus unexplained increased left ventricular wall thickness, older African-American patients with heart failure and thickened ventricles, those with preserved ejection fraction and unexplained heart failure, and patients with compatible findings on CMR/echocardiography or certain clinical syndromes without typical risk factors.\"},{\"question\":\"What imaging approaches are recommended and how are they used?\",\"answer\":\"Planar imaging supports visual interpretation and quantification via heart-to-lung ratio or rib uptake comparison, while 1-hour planar-only without SPECT is not recommended. SPECT (or SPECT/CT when available) can help separate blood pool from myocardial activity, evaluate distribution of uptake, assess the interventricular septum, and quantify uptake; whole-body planar imaging may be an optional adjunct to detect systemic involvement.\"}]","CARDIAC AMYLOIDOSIS ASNC PRACTICE POINTS - 99mTechnetium-Pyrophosphate Imaging for Transthyretin Cardiac Amyloidosis | PDF",1790938761]