# Amyloïde-PET bij negatieve botscintigrafie bevestigt geen cardiale amyloïdose

*geplaatst 2026-10-31 · Hartfalen · The international journal of cardiovascular imaging · doi 10.1007/s10554-026-03852-0 · https://hartvaat.nl/2026/10/23/amyloide-pet-bij-negatieve-botscintigrafie-bevestigt-geen-cardiale-amyloidose/*

Systematische review van negen studies naar de diagnostische waarde van amyloïde-targeting PET na een negatieve of laaggradige botscintigrafie bij verdenking op cardiale amyloïdose. In een onderzocht cohort met erfelijke transthyretine-amyloïdose was 87,0% van de patiënten PET-positief, maar dit alleen bewijst geen cardiale amyloïdose. De review benadrukt dat tomografische lokalisatie en onafhankelijke cardiologische verificatie essentieel blijven; een positieve PET zonder verdere verificatie volstaat niet voor de definitieve diagnose.

## English: Amyloid-targeted PET after negative or low-grade bone scintigraphy for cardiac amyloidosis: a systematic review.

A systematic review of nine studies evaluated amyloid-targeted PET following negative or low-grade bone scintigraphy in suspected cardiac amyloidosis. Among patients with hereditary transthyretin amyloidosis, 87.0% were PET-positive, yet this finding alone does not confirm cardiac amyloidosis. The authors emphasize that tomographic localization and independent cardiac verification remain essential, as PET positivity without corroborating evidence cannot establish the diagnosis.

## Abstract (original, from the publication)

To assess myocardial positron emission tomography (PET) positivity after negative or low-grade bone scintigraphy, while distinguishing test discordance from independently confirmed cardiac amyloidosis. PubMed, Scopus and Web of Science were searched through 5 August 2026, with targeted source assessment through 2 October 2026. Negative and low-grade imaging denoted Perugini grades 0 and 1, respectively; study-defined negative results were described separately. Eligibility required linked PET and bone-scan results with an extractable denominator. Acquisition modality, PET thresholds and cardiac reference standards were examined. A restricted synthesis required documented tomographic acquisition; a broader three-report synthesis was exploratory. Nine reports provided extractable paired results. In the hereditary transthyretin subgroup examined with carbon-11 Pittsburgh compound B, 20/23 participants were PET-positive after excluding one acquired, domino-transplant case. The exploratory pooled proportion was 87.0% (95% profile-likelihood confidence interval, 68.5-97.8%). Restriction to clearly documented cohort-wide tomography retained only two reports, precluding the planned pooled analysis. Uptake definitions and cardiac verification differed substantially. General diagnostic studies without complete bone-grade denominators, including REVEAL, were excluded from the eligible synthesis and retained as context. PET positivity is common in selected hereditary transthyretin cohorts with negative or low-grade bone scans, but does not establish cardiac amyloidosis or earlier diagnosis. Conditional diagnostic accuracy remains unresolved. Prospective paired studies require tomographic localization, tracer-specific thresholds and independent cardiac verification.

Auteurs: Agostino Chiaravalloti, Daniele Di Biagio

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Bron: The international journal of cardiovascular imaging, https://doi.org/10.1007/s10554-026-03852-0. Bijgewerkt 2026-10-24T01:44:22Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.