What does this research mean for the field?

Myocardial calcification from prior viral myocarditis can cause false-positive 99mTc-pyrophosphate uptake, necessitating SPECT/CT correlation to accurately diagnose cardiac amyloidosis. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To identify the cause of false-positive PYP uptake in a patient suspected of cardiac amyloidosis.

April 3, 2026

False-Positive 99mTc-Pyrophosphate Uptake Due to Myocardial Calcification from Prior Viral Myocarditis

Key Result

Myocardial calcification from prior viral myocarditis can cause false-positive 99mTc-pyrophosphate uptake, necessitating SPECT/CT correlation to rule out cardiac amyloidosis.

Key Points

To identify the cause of false-positive PYP uptake in a patient suspected of cardiac amyloidosis.
Patient underwent 99mTc-PYP imaging to evaluate cardiac amyloidosis.
Planar imaging and SPECT/CT were used to assess radiotracer uptake.
Cardiac MRI documented prior myocarditis with extensive fibrosis.
Planar imaging showed diffusely increased radiotracer uptake in the myocardium.
SPECT/CT correlated uptake to extensive myocardial calcifications.
False-positive PYP uptake was attributed to dystrophic calcification rather than true amyloid deposition.

Structured PICO

Population

1 patient evaluated for suspected cardiac amyloidosis with a history of severe viral myocarditis one year prior and extensive fibrosis documented by cardiac MRI

Intervention

99mTc-pyrophosphate (PYP) imaging with SPECT/CT correlation

Outcome

Source of radiotracer uptake (differentiation of true cardiac amyloid deposition from false-positive uptake)surrogate

SPECT/CT correlation is crucial during 99mTc-PYP imaging to differentiate true cardiac amyloidosis from false-positive uptake caused by dystrophic myocardial calcification.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

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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