Key result
Cardiac PET reveals heterogeneous FDG uptake in ATTR amyloidosis.
Why the study?
Diagnosis of ATTR amyloidosis typically relies on technetium-99m-based imaging or MRI, but the role of cardiac PET imaging in ATTR is not well defined.
Case Report (n=1)
No
Cardiac PET may demonstrate FDG uptake in ATTR amyloidosis, which can mimic inflammatory conditions like cardiac sarcoidosis and requires careful multimodality evaluation.
Requires multimodality imaging to distinguish ATTR from sarcoidosis on FDG-PET; leaves open prevalence and diagnostic implications.
BACKGROUND: Transthyretin amyloidosis (ATTR) is an infiltrative cardiomyopathy caused by deposition of misfolded transthyretin protein in the myocardium. Diagnosis typically relies on technetium-99m-based imaging or magnetic resonance imaging. CASE SUMMARY: A 72-year-old man presented for evaluation of multifocal premature ventricular contractions and nonsustained ventricular tachycardia after atrial fibrillation ablation. Cardiac positron emission tomography (PET) was highly suggestive of cardiac sarcoidosis. However, voltage-guided endomyocardial biopsy revealed a tissue diagnosis of ATTR. DISCUSSION: Although PET typically identifies inflammatory disease, this case suggests that fluorodeoxyglucose uptake may also occur in ATTR. TAKE-HOME MESSAGES: Diagnosis of ATTR often requires multimodality imaging to identify and differentiate from other infiltrative cardiomyopathies. Cardiac PET, although not classically used for this application, may have utility in the diagnostic pathway.
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Shah et al. (2026) conducted a case report in Transthyretin amyloidosis (ATTR) (n=1). Cardiac positron emission tomography (PET) was evaluated. Cardiac PET imaging demonstrated heterogeneous fluorodeoxyglucose uptake in a patient with transthyretin amyloidosis, suggesting FDG uptake can occur in ATTR.
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