2021 Advocacy Statements for the Role of 99m Tc-Pyrophosphate Scintigraphy in the Diagnosis of Transthyretin Cardiac Amyloidosis: A Report of the Taiwan Society of Cardiology and the Society of Nuclear Medicine of the Republic of China

• Published in: Acta Cardiologica Sinica 2021-05, Vol.37 (3), p.221
• Main Authors: Huang, Yih-Hwen, Lin, Yen-Hung, Yen, Ruoh-Fang, Hou, Charles Jia-Yin, Wang, Shan-Ying, Tsai, Shih-Chuan, Ho, Kung-Chu, Lin, Ming-Hsien, Tsao, Chin-Ho, Chang, Chih-Yung, Huang, Jin-Long, Cheng, Mei-Fang, Wu, Yen-Wen
• Format: Article
• Language: English
• ISSN: 1011-6842
• DOI: 10.6515/ACS.202105_37(3).20210420A

Transthyretin cardiac amyloidosis (ATTR-CM) is an increasingly recognized cause of heart failure with preserved ejection fraction. Favorable prognosis depends on early diagnosis and correct treatment strategy. Among patients for whom there is a high clinical suspicion of cardiac amyloidosis, Tc-labeled bone avid scintigraphy including Tc-pyrophosphate (PYP) scintigraphy may be of diagnostic and prognostic importance. Various international guidelines support the non-biopsy diagnosis of ATTR-CM using Tc-PYP scintigraphy, yet emphasize the gap in standardization of acquisition and imaging analysis protocols, as well as the appropriateness of its clinical use. Therefore, a joint expert consensus has been reached by the Taiwan Society of Cardiology and the Society of Nuclear Medicine of the Republic of China, to advocate for the application of Tc-PYP scintigraphy in the diagnosis of ATTR-CM. This article aims to highlight the recommendations on image acquisition, qualitative and quantitative assessments of cardiac Tc-PYP uptake, and diagnostic algorithms. We hope the implementation of these recommendations in Taiwan will facilitate the process and enhance the diagnostic rate of ATTR-CM.