European journal of radiology · 2025
Head-to-head comparison of [18F]florbetapir and [18F]FDG PET for the early detection of amyloidosis in systemic amyloidosis and plasma cell dyscrasias.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Kong Yanyan, Cao Lei, He Boyan, Zhou Zhongwen, Zhang Minmin, Zhang Qian, Wang Qian, Wang Wei, Zhu Haoxiang, Xiao Jianfei, Rominger Axel, Guan Yihui, Tan Haibo, Ni Ruiqing
Аннотация
RATIONALE AND OBJECTIVES: Systemic amyloidosis is underdiagnosed in light-chain amyloidosis (AL), as is plasma cell dyscrasias (PCD). Early detection and accurate evaluation of organ involvement in systemic amyloidosis remain critical challenges. We aimed to assess the utility of [18F]florbetapir (FBP) and [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) for the early detection and evaluation of organ involvement in systemic amyloidosis.
MATERIALS AND METHODS: We included 66 participants and performed biochemical assays in serum and urine and whole-body PET/computed tomography using [18F]FBP and [18F]FDG, followed by visual, maximum standardized uptake value (SUVmax), and target-to-background ratio (TBR) analyses. The clinical evaluation of organ involvement was based on the histological analysis of tissue biopsies obtained from suspected organs in AL and PCD cases.
RESULTS: [18F]FBP SUVmax and TBR analyses revealed comparable uptake in AL patients and significantly greater uptake than in PCD patients. Distinct regional distributions of [18F]FBP and [18F]FDG were observed between the PCD and AL groups. The [18F]FBP SUVmax and visual analysis provided comparable measures of organ involvement and demonstrated high sensitivity, outperforming [18F]FDG in detecting organ amyloidosis in both PCD and AL patients. More organ involvement was detected by [18F]FBP PET (SUVmax or visual) than by biopsies based evaluation.
CONCLUSION: [18F]FBP PET, through both visual and SUVmax analysis, is more sensitive than [18F]FDG PET and biopsy-based analysis for detecting organ amyloidosis in PCD and AL patients. It serves as a valuable noninvasive method for the early and accurate detection of systemic amyloidosis, with the potential to improve diagnostic precision and facilitate timely intervention in systemic amyloidosis patients.
MATERIALS AND METHODS: We included 66 participants and performed biochemical assays in serum and urine and whole-body PET/computed tomography using [18F]FBP and [18F]FDG, followed by visual, maximum standardized uptake value (SUVmax), and target-to-background ratio (TBR) analyses. The clinical evaluation of organ involvement was based on the histological analysis of tissue biopsies obtained from suspected organs in AL and PCD cases.
RESULTS: [18F]FBP SUVmax and TBR analyses revealed comparable uptake in AL patients and significantly greater uptake than in PCD patients. Distinct regional distributions of [18F]FBP and [18F]FDG were observed between the PCD and AL groups. The [18F]FBP SUVmax and visual analysis provided comparable measures of organ involvement and demonstrated high sensitivity, outperforming [18F]FDG in detecting organ amyloidosis in both PCD and AL patients. More organ involvement was detected by [18F]FBP PET (SUVmax or visual) than by biopsies based evaluation.
CONCLUSION: [18F]FBP PET, through both visual and SUVmax analysis, is more sensitive than [18F]FDG PET and biopsy-based analysis for detecting organ amyloidosis in PCD and AL patients. It serves as a valuable noninvasive method for the early and accurate detection of systemic amyloidosis, with the potential to improve diagnostic precision and facilitate timely intervention in systemic amyloidosis patients.