Cardiac Scintigraphy with Bone-Avid Tracers: Old and New Applications

Owing to advances in cardiac scintigraphy with technetium-99m-labeled bone-avid radiotracers, transthyretin cardiac amyloidosis is now recognized as a prevalent cause of heart failure in the elderly. Technetium-99m-labeled bone-avid radiotracers, in the absence of a clonal abnormality, can noninvasively diagnose transthyretin cardiac amyloidosis without a need for an endomyocardial biopsy. Moreover, novel quantitative approaches to technetium-99m-labeled bone-avid radiotracer cardiac scintigraphy are further expanding its applications to disease monitoring. This chapter reviews current and novel applications of bone-avid tracer cardiac scintigraphy in the management of patients with transthyretin cardiac amyloidosis.