DPD scan

A DPD scan is a type of nuclear medicine imaging test which uses radioactive technetium-99m (99mTc) 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.[1]

For the amyloid scan used in diagnosis of Alzheimer's disease, see Positron emission tomography § Neuroimaging.
Amyloid deposition in aortic stenosis shown by DPD scan

DPD is a diphosphonate and can be used as an alternative to HDP or MDP in nuclear medicine bone scintigraphy.[2]

Procedure

DPD scanning typically uses a gamma camera to obtain SPECT images, with an injection followed by an initial scan after 5 minutes, and a second scan after 3 hours.[3]

Images are often scored using the "Perugini system" whereby:[4][5]

  • Grade 0 – no cardiac uptake and normal bone uptake
  • Grade 1 – cardiac uptake which is less intense than the bone signal
  • Grade 2 – cardiac uptake with intensity similar or greater than bone signal
  • Grade 3 – cardiac uptake with much attenuated or absent bone signal

Availability

DPD is not currently available in the United States.[6]

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See also

References
  1. Iskandrian, Ami E.; Garcia, Ernest V. (2015). Nuclear Cardiac Imaging: Principles and Applications. Oxford University Press. p. 543. ISBN 9780199392094.
  2. Fogelman, Ignac (2012). Bone Scanning in Clinical Practice. Springer. ISBN 9781447114079.
  3. "Amyloidosis Overview". Centre for Amyloidosis and Acute Phase Proteins. University College London. 22 May 2018. Retrieved 27 June 2019.
  4. Perugini, Enrica; Guidalotti, Pier Luigi; Salvi, Fabrizio; et al. (September 2005). "Noninvasive Etiologic Diagnosis of Cardiac Amyloidosis Using 99m Tc-3,3-Diphosphono-1,2-Propanodicarboxylic Acid Scintigraphy". Journal of the American College of Cardiology. 46 (6): 1076–1084. doi:10.1016/j.jacc.2005.05.073. PMID 16168294.
  5. Hutt, David F; Fontana, Marianna; Burniston, Maria; et al. (December 2017). "Prognostic utility of the Perugini grading of 99mTc-DPD scintigraphy in transthyretin (ATTR) amyloidosis and its relationship with skeletal muscle and soft tissue amyloid". European Heart Journal - Cardiovascular Imaging. 18 (12): 1344–1350. doi:10.1093/ehjci/jew325. PMID 28159995.
  6. Bokhari, Sabahat; Shahzad, Reehan; Castaño, Adam; Maurer, Mathew S. (26 October 2013). "Nuclear imaging modalities for cardiac amyloidosis". Journal of Nuclear Cardiology. 21 (1): 175–184. doi:10.1007/s12350-013-9803-2. PMC 4302756.
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