Key result
False-positive 99mTc-PYP uptake from viral myocarditis calcification requires SPECT/CT correlation to rule out cardiac amyloidosis.
SPECT/CT correlation is crucial during 99mTc-PYP imaging to differentiate true cardiac amyloidosis from false-positive uptake caused by dystrophic myocardial calcification.
SPECT/CT correlation is essential in 99mTc-PYP imaging to avoid misdiagnosis; extends known false-positive uptake etiologies.
A patient underwent 99mTc-pyrophosphate (PYP) imaging to evaluate for suspected cardiac amyloidosis. Planar imaging demonstrated diffusely increased radiotracer uptake throughout the left ventricular myocardium. On SPECT/CT, these regions of uptake corresponded to extensive myocardial calcifications. Patient had a history of severe myocarditis a year prior with extensive fibrosis documented by cardiac MRI. This case underscores the importance of SPECT/CT correlation in differentiating true cardiac amyloid deposition from false-positive PYP uptake due to dystrophic myocardial calcification.
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Eshghi et al. (2026) studied this question. Myocardial calcification from prior viral myocarditis can cause false-positive 99mTc-pyrophosphate uptake, necessitating SPECT/CT correlation to rule out cardiac amyloidosis.
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