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Nuclear medicine techniques for the diagnosis of cardiac amyloidosis: the state of the art

Amyloidosis is a disease characterized by the deposition of amorphous protein material in the extracellular space which leads to progressive dysfunction of the affected organ. The forms of amyloidosis that most frequently involve the heart are transthyretin amyloidosis (ATTR) and immunoglobulin light chain amyloidosis (AL). Nuclear medicine offers numerous imaging techniques for the evaluation of patients with cardiac amyloidosis, and in the last decade osteophilic tracer scintigraphy has assumed a fundamental role in the diagnostic process of this disease. New PET radiopharmaceuticals for the detection of amyloid deposits are proving very effective in diagnosing the presence of AL amyloidosis and could soon allow a differential diagnosis without the need for invasive and potentially risky techniques such as endomyocardial biopsy.