68 Ga-FAPI-46 PET/CT demonstrated intense myocardial uptake in a 56-year-old man with an equivocal standard workup, successfully guiding a repeat biopsy to confirm AL cardiac amyloidosis.
Case Report (n=1)
Does 68 Ga-FAPI-46 PET/CT improve diagnostic accuracy in patients with suspected AL cardiac amyloidosis and an equivocal conventional workup?
68 Ga-FAPI-46 PET/CT may serve as a valuable diagnostic tool to clarify the diagnosis of AL cardiac amyloidosis when conventional imaging and biopsies yield equivocal results.
AL cardiac amyloidosis (CA) is challenging to diagnose due to limitations of biopsy and conventional imaging. Endomyocardial biopsy (EMB) can yield false negatives, and 99m Tc-pyrophosphate scintigraphy is less reliable for AL amyloidosis. We report a 56-year-old man with progressive dyspnea, palpitations, and macroglossia, in whom echocardiography revealed hypertrophic cardiomyopathy with reduced ejection fraction. Cardiac MRI, bone marrow biopsy (BMB), and EMB were inconclusive, while PYP scintigraphy was equivocal. 68 Ga-FAPI-46 PET/CT demonstrated intense myocardial uptake, prompting a repeat BMB confirming AL amyloidosis. This case underscores the emerging role of FAPI PET/CT in clarifying diagnosis after an equivocal workup, enabling targeted therapy.
Kumar et al. (Wed,) conducted a case report in AL cardiac amyloidosis (n=1). 68 Ga-FAPI-46 PET/CT was evaluated. 68 Ga-FAPI-46 PET/CT demonstrated intense myocardial uptake in a 56-year-old man with an equivocal standard workup, successfully guiding a repeat biopsy to confirm AL cardiac amyloidosis.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: