DPD scan
{{short description|Nuclear medicine scan}}
{{For|the amyloid scan used in diagnosis of Alzheimer's disease|Positron emission tomography#Neuroimaging}}
File:Amyloid deposition (DPD scan).png shown by 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.{{cite book |last1=Iskandrian |first1=Ami E. |last2=Garcia |first2=Ernest V. |title=Nuclear Cardiac Imaging: Principles and Applications |date=2015 |publisher=Oxford University Press |isbn=9780199392094 |page=543 |url=https://books.google.com/books?id=2ot2CgAAQBAJ&pg=PA543 |language=en}}
DPD is a diphosphonate and can be used as an alternative to HDP or MDP in nuclear medicine bone scintigraphy.{{cite book |last1=Fogelman |first1=Ignac |title=Bone Scanning in Clinical Practice |date=2012 |publisher=Springer |isbn=9781447114079 |url=https://books.google.com/books?id=Yj5FBgAAQBAJ&pg=PA35 |language=en}}
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.{{cite web |title=Amyloidosis Overview |url=https://www.ucl.ac.uk/amyloidosis/national-amyloidosis-centre/amyloidosis-overview |website=Centre for Amyloidosis and Acute Phase Proteins |publisher=University College London |accessdate=27 June 2019 |language=en |date=22 May 2018}}
Images are often scored using the "Perugini system" whereby:{{cite journal |last1=Perugini |first1=Enrica |last2=Guidalotti |first2=Pier Luigi |last3=Salvi |first3=Fabrizio |last4=Cooke |first4=Robin M.T. |last5=Pettinato |first5=Cinzia |last6=Riva |first6=Letizia |last7=Leone |first7=Ornella |last8=Farsad |first8=Mohsen |last9=Ciliberti |first9=Paolo |last10=Bacchi-Reggiani |first10=Letizia |last11=Fallani |first11=Francesco |last12=Branzi |first12=Angelo |last13=Rapezzi |first13=Claudio |title=Noninvasive Etiologic Diagnosis of Cardiac Amyloidosis Using 99m Tc-3,3-Diphosphono-1,2-Propanodicarboxylic Acid Scintigraphy |journal=Journal of the American College of Cardiology |date=September 2005 |volume=46 |issue=6 |pages=1076–1084 |doi=10.1016/j.jacc.2005.05.073 |pmid=16168294|doi-access=| display-authors = 3}}{{cite journal |last1=Hutt |first1=David F |last2=Fontana |first2=Marianna |last3=Burniston |first3=Maria |last4=Quigley |first4=Ann-Marie |last5=Petrie |first5=Aviva |last6=Ross |first6=James C |last7=Page |first7=Joanne |last8=Martinez-Naharro |first8=Ana |last9=Wechalekar |first9=Ashutosh D |last10=Lachmann |first10=Helen J |last11=Quarta |first11=Candida C |last12=Rezk |first12=Tamer |last13=Mahmood |first13=Shameem |last14=Sachchithanantham |first14=Sajitha |last15=Youngstein |first15=Taryn |last16=Whelan |first16=Carol J |last17=Lane |first17=Thirusha |last18=Gilbertson |first18=Janet A |last19=Rowczenio |first19=Dorota |last20=Hawkins |first20=Philip N |last21=Gillmore |first21=Julian D |title=Prognostic utility of the Perugini grading of 99mTc-DPD scintigraphy in transthyretin (ATTR) amyloidosis and its relationship with skeletal muscle and soft tissue amyloid |journal=European Heart Journal - Cardiovascular Imaging |date=December 2017 |volume=18 |issue=12 |pages=1344–1350 |doi=10.1093/ehjci/jew325 |pmid=28159995|doi-access=free| display-authors = 3}}
- 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.{{cite journal |last1=Bokhari |first1=Sabahat |last2=Shahzad |first2=Reehan |last3=Castaño |first3=Adam |last4=Maurer |first4=Mathew S. |title=Nuclear imaging modalities for cardiac amyloidosis |journal=Journal of Nuclear Cardiology |date=26 October 2013 |volume=21 |issue=1 |pages=175–184 |doi=10.1007/s12350-013-9803-2 |pmid=24162886 |pmc=4302756}}