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Recent studies describe prognostic value of imaging biomarkers from bone scintigraphy and\n                      <jats:sup>18<\/jats:sup>\n                      F-Florbetapir. The aim of this study was to evaluate the value of imaging biomarkers from\n                      <jats:sup>18<\/jats:sup>\n                      F-Florbetaben PET, cardiac magnetic resonance (CMR), and echocardiography imaging for prediction of major adverse cardiac events (MACE) in comparison to serum biomarkers in patients with different types of CA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients who underwent cardiac\n                      <jats:sup>18<\/jats:sup>\n                      F-Florbetaben PET\/MRI were prospectively enrolled and received clinical follow-up for up to 36 months and MACE were reported (NCT07154381). Scans were reported by two blinded, nuclear medicine physicians. Imaging biomarkers including average retention index (RI), T1 mapping\/ extracellular volume (ECV) and serological markers were estimated and their association with MACE free survival was analyzed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-one patients with confirmed CA were enrolled. MACEs were reported in 14 of 21 patients (66.7%). Higher average RI was the only imaging biomarker that was a significant predictor for MACE in uni- and multivariate analysis (HR = 4.02, 95%CI: 1.25-12.9, p &lt; 0.05). N-terminal pro-B-type natriuretic peptide (NT-proBNP) was a significant predictor in uni- but not in multivariate analysis. Patients with AL-CA showed a higher rate of MACE than patients with other subtypes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Integrated\n                      <jats:sup>18<\/jats:sup>\n                      F-Florbetaben PET\/MR allows diagnosis, subtype differentiation and outcome predication of CA. The average RI was the only significant and independent prognostic imaging biomarker of MACE. Future prospective studies are warranted to investigate benefits for patient management and risk assessment in larger cohorts.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00259-025-07733-x","type":"journal-article","created":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T08:22:50Z","timestamp":1770452570000},"page":"3973-3984","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prognostic parameters and detection of cardiac amyloidosis with hybrid 18F-Florbetaben-PET\/MRI: an exploratory observational study"],"prefix":"10.1007","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1751-8837","authenticated-orcid":false,"given":"Lukas","family":"Kessler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wibke","family":"Tonscheidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Nassenstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Settelmeier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Carpinteiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. 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All participants agreed to publication.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate<!--Emphasis Type='Bold' removed-->\/publish"}},{"value":"The study was approved by the local institutional review board of the University of Duisburg-Essen, Germany (registry number: 19-8798-BO). The observational trial is registered at clinicaltrials.gov (NCT07154381).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"This work was funded by a research grant from Pfizer to C. Rischpler. D. Kersting. D. Kersting reports a research grant from Pfizer, personal fees from GE Healthcare and Novartis, travel grants from Life Molecular Imaging and Sanofi and speaker honoraria from Pfizer, outside the submitted work.. C. Rischpler reports a research grant from Pfizer. T. Hagenacker received speaker and advisory fees from Alnylam and AstraZeneca. W.P. Fendler reports fees from SOFIE Bioscience (research funding), Janssen (consultant, speaker), Perceptive (consultant, image review), Bayer (consultant, speaker, research funding), Novartis (speaker, consultant), Telix (speaker), GE Healthcare (speaker, consultant), Eczac\u0131ba\u015f\u0131 Monrol (speaker), Abx (speaker), Amgen (speaker), Urotrials (speaker), Lilly (consultant), AstraZeneca (research funding) outside of the submitted work. B.M. Schaarschmidt received a research grant from PharmaCept GmbH for an investigator-initiated study not related to this paper, travel grant form Bayer AG and speaker honorarium from AstraZeneca. S. Wernhart has received honoraria for lectures from Bristol-Myers Squibb, not related to this study. The other authors have nothing to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}}]}}