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Standard diagnostic workup includes\n                      <jats:sup>99m<\/jats:sup>\n                      Tc-DPD scintigraphy performed after 2.5\u20133\u00a0h. The purpose of this study is to compare early (1\u00a0h after injection) to late imaging of\n                      <jats:sup>99m<\/jats:sup>\n                      Tc-DPD scintigraphy and SPECT for the detection of ATTR-CM. Early imaging could improve patient comfort and examination efficiency.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      50 patients undergoing\n                      <jats:sup>99m<\/jats:sup>\n                      Tc-DPD scintigraphy and SPECT for suspected ATTR-CM were included. Imaging was performed at both 1\u00a0h and 2.5\u20133\u00a0h post-injection. Tracer uptake was assessed visually (Perugini score), semi-quantitatively (e.g., heart-to-mediastinum ratio, HMR), and quantitatively (e.g., maximum standardized uptake value, SUV\n                      <jats:sub>max<\/jats:sub>\n                      ). ATTR-CM was diagnosed in 28% of patients. Median visual Perugini score was significantly higher for early imaging (0.5 vs. 0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Findings were validated using an external validation cohort. Intraclass correlation coefficients between early and late imaging were very good. Visual evaluation of early imaging demonstrated comparable sensitivity, specificity, and overall diagnostic accuracy to late imaging. HMR and SUV\n                      <jats:sub>max<\/jats:sub>\n                      from early imaging showed higher diagnostic accuracy. No false-negative results were observed. Visual evaluation using the Perugini score was slightly less consistent between readers in early compared to late imaging, with lower inter-observer agreement at 1\u00a0h.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Early\n                      <jats:sup>99m<\/jats:sup>\n                      Tc-DPD imaging provides diagnostic performance equivalent to conventional late imaging while substantially enhancing patient comfort and workflow efficiency. Adoption of early imaging protocols, complemented by quantitative and semi-quantitative analysis, may streamline ATTR-CM diagnostics, enabling timely diagnosis and treatment.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13550-026-01466-0","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T18:55:01Z","timestamp":1781290501000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early timepoint 99mTc-DPD whole body scintigraphy and quantitative SPECT\/CT imaging for diagnosis of cardiac ATTR amyloidosis"],"prefix":"10.1186","volume":"16","author":[{"given":"Stephan","family":"Settelmeier","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Kessler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah","family":"Hammersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Papathanasiou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Rischpler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Carpinteiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Oubari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Michel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Vogel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Wollenweber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Ning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Hacker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemens P.","family":"Spielvogel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zohreh","family":"Varasteh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang P.","family":"Fendler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Barbato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro Fragoso","family":"Costa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Leyser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tienush","family":"Rassaf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Herrmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tugce","family":"Telli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8451-1830","authenticated-orcid":false,"given":"David","family":"Kersting","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"key":"1466_CR1","doi-asserted-by":"publisher","first-page":"1554","DOI":"10.1093\/eurheartj\/ehab072","volume":"42","author":"P Garcia-Pavia","year":"2021","unstructured":"Garcia-Pavia P, Rapezzi C, Adler Y, Arad M, Basso C, Brucato A, et al. 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Observational study was approved by the local institutional ethics board in accordance with the Declaration of Helsinki and its later amendments (Medical Faculty of the University of Duisburg-Essen, 21-10243 BO) and written informed consent was requested. For validation, observational study was approved by the local institutional ethics board (EK769\/2010). Each individual gave written informed consent prior to imaging. Findings were compared to the Essen cohort. Each individual gave written informed consent to participate prior to imaging.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the participants for publication of this study and accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"C. P. Spielvogel declares speaker and consulting fees from Pfizer. All other authors declare that there is no potential conflict of interest regarding this work.C. Rischpler, K. Herrmann and M. Hacker are editors of this journal.S. Settelmeier: received speaker honoraria from Astra Zeneca outside of the submitted work.A. Carpinteiro: Personal fees outside the submitted work for consulting and\/or lectures from Alexion, Alnylam, Amgen, GSK, Janssen, Pfizer, Sanofi and Takeda and travel and congress participation grants from Janssen.M. Papathanasiou has received speaker and consultancy fees from Cytokinetics, Pfizer, Bristol Myers Squibb, AstraZeneca, Alnylam, Bayer, Alexion, Prothena, Janssen, Zoll, and Novo Nordisk, has participated in clinical trials sponsored by AstraZeneca, Novo Nordisk, Alnylam, and Cytokinetics and received research grants from Alnylam.C. Rischpler: Personal fees outside the submitted work for speaker honoraria (Alnylam, Bayer, Curium, GE Healthcare, Novartis, Pfizer, Rotop, Siemens Healthineers) and for consultancy (Pfizer, Novartis).T. Rassaf: Personal fees outside the submitted work from Novartis, Bristol Myers Squibb, Bayer, Daiichi Sankyo and AstraZeneca and Pfizer. Research funding: German Research Foundation (DFG; RA 969\/12 \u2212 1). Co-Founder of Mycor GmbH, a company focusing on artificial intelligence-based electrocardiography algorithms or the detection of amyloidosis [\n                      \n                      ]. Co-founder of Bimyo GmbH, a company that develops cardioprotective peptides.L. Michel: Personal fees outside the submitted work from Bayer, Bristol Myers Squibb, Alnylam, AstraZeneca, IFFM e. V. and from Bund der Niedergelassenen Kardiologen (BNK). Research funding: UME funding from the Faculty of Medicine, University of Duisburg-Essen and Bayer for an investigator\/institution sponsored collaborative study outside the submitted work. S.O. received travel and congress participation grants from Janssen and Alexion.M. Hacker and C. P. Spielvogel are members of the editorial board of the Journal.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"92"}}