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Bone scintigraphy (BS) is one of the main screening tools for ATTR-CA but also used for various other reasons. The objective was to evaluate whether all CA cases are detected and what happens during follow-up. All routine BS performed at the Maastricht University Medical Center (May 2012\u2013August 2020) were screened for the presence of CA. Scans performed for suspected CA were excluded. A Perugini stage \u22651 was classified as positive necessitating further examination. The electronic medical record system was evaluated for any contact with cardiology or other specialists until 2021. Of the 2738 BS evaluated, 40 scans (1.46%; median age 73.5 [IQR: 65.8\u201379.5], 82.5% male) were positive (Perugini grade 1: 31\/77.5%, grade 2: 6\/15%, grade 3: 3\/7.5%); the potential diagnosis ATTR-CA was not seen in 38 patients (95%) by the nuclear medicine specialist. During follow-up, 19 out of those 40 patients (47.5%) underwent cardiac evaluation without diagnosing CA. Available echocardiograms of patients with a positive BS showed left ventricular hypertrophy, a preserved ejection fraction, and diastolic dysfunction \u22652 in 9\/47%, 10\/53%, and 4\/21% of patients, respectively. Additionally, 20 (50%) patients presented to at least one specialty with symptoms indicative of cardiac amyloidosis. The prevalence of a positive BS indicating potential CA in an unselected population is low but substantial. The majority was not detected which asks for better awareness for CA of all involved specialists to ensure appropriate treatment and follow-up.<\/jats:p>\n                <jats:p><jats:bold>Graphical abstract<\/jats:bold><\/jats:p>","DOI":"10.1007\/s10554-024-03085-z","type":"journal-article","created":{"date-parts":[[2024,3,23]],"date-time":"2024-03-23T16:01:41Z","timestamp":1711209701000},"page":"1183-1192","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Detection of cardiac amyloidosis on routine bone scintigraphy: an important gatekeeper role for the nuclear medicine physician"],"prefix":"10.1007","volume":"40","author":[{"given":"Mohit","family":"Nebhwani","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karina","family":"Chaibekava","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anouk","family":"Achten","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marish I. 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Also, he has also received unrestricted grants, paid to institute from Astra Zeneca and Pfizer. SSvW was provided a research grant from Pfizer. AA was provided a research grant and contribution for a congress fee from Pfizer. HPB received unrestricted research grants from Vifor, Novartis, Roche Diagnostics and acts as advisor for Vifor, Novartis, Boehringer-Ingelheim, AstraZeneca, Roche-Diagnostics, Medtronic. VvE has received speaker fees, paid to institute, from Astra Zeneca, Boehringer Ingelheim, and Janssen. She has received unrestricted grants, paid to institute from Astra Zeneca, Boehringer Ingelheim, Pfizer and Vifor. PvdM is supported by a grant from the European Research Council (ERC CoG 101045236, DISSECT-HF). PvdM received consultancy fees and\/or grants from Novartis, Pharmacosmos, Vifor Pharma, Astra Zeneca, Pfizer, Pharma Nord, BridgeBio, Novo Nordisk and Ionis, all paid to the institute. MIFJO received consultancy fees from Alnylam, Pfizer, Johnson & Johnson and Novartis paid to the University Medical Center Utrecht, outside the current work. MM received a research grant from BMS, paid to the ErasmusMC, outside the current work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}