1
|
Santagati G, Cataldo E, Columbano V, Chatrenet A, Penna D, Pelosi E, Hachemi M, Gendrot L, Nielsen L, Cinquantini F, Saulnier P, Arena V, Boursot C, Piccoli GB. Positron Emission Tomography Can Support the Diagnosis of Dialysis-Related Amyloidosis. J Clin Med 2019; 8:jcm8091494. [PMID: 31546847 PMCID: PMC6781261 DOI: 10.3390/jcm8091494] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 08/31/2019] [Accepted: 09/10/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The improvements in dialysis have not eliminated long-term problems, including dialysis-related amyloidosis (DRA), caused by Beta-2 microglobulin deposition. Several types of scintigraphy have been tested to detect DRA, none entered the clinical practice. Aim of the study was to assess the potential of PET-FDG scan in the diagnosis of DRA. METHODS Forty-six dialysis patients with at least one PET scan (72 scans) were selected out 162 patients treated in 2016-2018. Subjective global assessment (SGA), malnutrition inflammation score (A), Charlson Comorbidity Index (CCI), were assessed at time of scan; 218 age-matched cases with normal kidney function were selected as controls. PET scans were read in duplicate. Carpal tunnel syndrome was considered a proxy for DRA. A composite "amyloid score" score considered each dialysis year = 1 point; carpal tunnel-DRA = 5 points per site. Logistic regression, ROC curves and a prediction model were built. RESULTS The prevalence of positive PET was 43.5% in dialysis, 5% in controls (p < 0.0001). PET was positive in 14/15 (93.3%) scans in patients with carpal tunnel. PET sensitivity for detecting DRA was 95% (specificity 64%). Carpal tunnel was related to dialysis vintage and MIS. A positive PET scan was significantly associated with dialysis vintage, MIS and amyloid score. A prediction model to explain PET positivity combined clinical score and MIS, allowing for an AUC of 0.906 (CI: 0.813-0.962; p < 0.001). CONCLUSIONS PET-FDG may identify DRA, and may be useful in detecting cases in which inflammation favours B2M deposition. This finding, needing large-scale confirmation, could open new perspectives in the study of DRA.
Collapse
Affiliation(s)
| | | | | | | | - Daniele Penna
- Affidea IRMET, PET CENTER, Torino via Onorato Vigliani 89, 10135 Torino, Italy.
| | - Ettore Pelosi
- Affidea IRMET, PET CENTER, Torino via Onorato Vigliani 89, 10135 Torino, Italy.
| | - Mammar Hachemi
- Medecine Nucleaire, Centre Hospitalier du Mans, 72037 Le Mans, France.
| | | | - Louise Nielsen
- Néphrologie, Centre Hospitalier du Mans, 72037 Le Mans, France.
| | | | | | - Vincenzo Arena
- Affidea IRMET, PET CENTER, Torino via Onorato Vigliani 89, 10135 Torino, Italy.
| | - Charles Boursot
- Medecine Nucleaire, Centre Hospitalier du Mans, 72037 Le Mans, France.
| | - Giorgina Barbara Piccoli
- Néphrologie, Centre Hospitalier du Mans, 72037 Le Mans, France.
- Dipartimento di Scienze Cliniche e Biologiche, Università di Torino, 10100 Torino, Italy.
| |
Collapse
|
2
|
Dezutter NA, Landman WJ, Jager PL, de Groot TJ, Dupont PJ, Tooten PC, Zekarias B, Gruys E, Verbruggen AM. Evaluation of 99mTc-MAMA-chrysamine G as an in vivo probe for amyloidosis. Amyloid 2001; 8:202-14. [PMID: 11676297 DOI: 10.3109/13506120109007363] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
To date, systemic amyloidosis is diagnosed histologically using Congo red staining or in vivo using iodine-123 labelled serum amyloid P component (123I-SAP) scintigraphy. We developed 99mTc-MAMA-CG, a 99mTc-labelled derivative of the lipophilic Congo red analogue chrysamine G (CG), as a possible alternative to 123I-SAP. In vivo 99mTc-MAMA-CG scintigraphy, performed in chickens with spontaneous joint amyloidosis, resulted as soon as 10 min after injection in scintigraphic images showing uptake of activity in amyloid-loaded organs (liver, joints). One of these chickens was studied also with 123I-SAP resulting in scintigraphic images revealing 123I-SAP binding to amyloid deposits in the liver. However, up to 11 h after injection no radioactivity was visible in the amyloid positive joints. In vitro autoradiography, performed on sections of chicken joints with Enterococcus faecalis induced amyloid arthropathy (chjAA), demonstrated the failure of 99mTc-MAMA-CG to bind significantly to amyloid deposits in the presence of 10 microM Congo red The specificity of 99mTc-MAMA-CG localisation was also established by the absence of 99mTc-MAMA-CG binding in non-amyloidotic organs in vitro and in vivo. 99mTc-MAMA-CG did not show any sign of acute toxicity. These findings establish the usefulness of 99mTc-MAMA-CG as a non-invasive in vivo diagnostic probe in chickens with amyloid arthropathy and suggest that it may also be applicable to human amyloidosis.
Collapse
Affiliation(s)
- N A Dezutter
- Laboratory of Radiopharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, University of Leuven, Belgium
| | | | | | | | | | | | | | | | | |
Collapse
|