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A DPD scan is a type of nuclear medicine imaging test which uses radioactive technetium-99m (99m Tc) and 3,3-diphosphono-1,2-propanodicarboxylic acid (DPD) to diagnose cardiac amyloidosis. The radiopharmaceutical is taken up only in patients with ATTR amyloidosis , making it a useful tool to differentiate from AL amyloidosis .
Cardiac amyloidosis is a subcategory of amyloidosis where there is depositing of the protein amyloid in the cardiac muscle and surrounding tissues. Amyloid, a misfolded and insoluble protein, can become a deposit in the heart's atria, valves, or ventricles .
A number of imaging techniques such as a Nuclear Medicine PYP scan, DPD scan or SAP scan are also in use. [23] A sample of tissue can be biopsied or obtained directly from the affected internal organ, but the first-line site of biopsy is subcutaneous abdominal fat, known as a "fat pad biopsy", due to its ease of acquisition.
To date, 37 human proteins have been found to form amyloid in pathology and be associated with well-defined diseases. [2] The International Society of Amyloidosis classifies amyloid fibrils and their associated diseases based upon associated proteins (for example ATTR is the group of diseases and associated fibrils formed by TTR). [3]
AL amyloidosis is caused by the deposition of abnormal antibody free light chains. The abnormal light chains are produced by monoclonal plasma cells, and, although AL amyloidosis can occur without diagnosis of another disorder, it is often associated with other plasma cell disorders, such as multiple myeloma and Waldenström's macroglobulinemia. [6]
A SAP scan is a type of nuclear medicine imaging test which uses iodine-123 (123 I) and serum amyloid P component (SAP) to diagnose amyloidosis. [ 1 ] [ 2 ] In patients with amyloidosis, large deposits of SAP coat the affected organs, in addition to the low levels normally found in the blood stream. [ 3 ]
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