{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T11:34:24Z","timestamp":1762083264015,"version":"build-2065373602"},"reference-count":36,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,28]],"date-time":"2022-12-28T00:00:00Z","timestamp":1672185600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Transthyretin cardiac amyloidosis (ATTR) is a rare cardiac protein deposition disease characterized by progressive thickening of both ventricles, the inter-atrial-ventricular septum and the atrioventricular valves. The gold standard method for diagnosing this rare pathology is endomyocardial biopsy. If this method cannot be used, the alternative is a mixture of clinical and paraclinical tests. Over the course of five years, we examined 58 patients suspected of cardiac amyloidosis based on electrocardiography and ultrasonography criteria, who had been sent for bone scintigraphy in order to determine the presence of ATTR cardiac amyloidosis. However, the final diagnosis was set by correlating the bone scan with genetic testing, free light chain dosage or soft tissue biopsy. Based on the final diagnosis we analyzed the patients\u2019 predominant biomarkers in order to determine a possible correlation between them. This analysis is designed to help the general practitioner set a possible cardiac amyloidosis diagnosis.<\/jats:p>","DOI":"10.3390\/diagnostics13010083","type":"journal-article","created":{"date-parts":[[2022,12,28]],"date-time":"2022-12-28T08:42:22Z","timestamp":1672216942000},"page":"83","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Role of Diphosphonates Bone Scintigraphy in Correlation with Biomarkers for a Personalized Approach to ATTR Cardiac Amyloidosis in North-Eastern Romania"],"prefix":"10.3390","volume":"13","author":[{"given":"Teodor Marian","family":"Ionescu","sequence":"first","affiliation":[{"name":"Department of Biophysics and Medical Physics, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Iasi, 700115 Iasi, Romania"},{"name":"Department of Pathophysiology, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Iasi, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9240-2175","authenticated-orcid":false,"given":"Manuela","family":"Ciocoiu","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Iasi, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2653-4919","authenticated-orcid":false,"given":"Raoul-Vasile","family":"Lupu\u0219oru","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Iasi, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irena","family":"Grierosu","sequence":"additional","affiliation":[{"name":"Department of Biophysics and Medical Physics, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Iasi, 700115 Iasi, Romania"},{"name":"Nuclear Medicine Laboratory, \u201cSf. Spiridon\u201d Emergency County Clinical Hospital Iasi, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Radu Andy","family":"Sasc\u0103u","sequence":"additional","affiliation":[{"name":"Cardiology Department, Cardiovascular Diseases Institute \u201cProf. Dr. George I.M. Georgescu\u201d, 700503 Iasi, Romania"},{"name":"Department of Internal Medicine-Cardiology, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Iasi, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wael","family":"Jalloul","sequence":"additional","affiliation":[{"name":"Department of Biophysics and Medical Physics, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Iasi, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roxana","family":"Iacob","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Laboratory, Regional Institute of Oncology Iasi, 700483 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cati Raluca","family":"Stolniceanu","sequence":"additional","affiliation":[{"name":"Department of Biophysics and Medical Physics, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Iasi, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Clement","sequence":"additional","affiliation":[{"name":"Cardiology Department, Cardiovascular Diseases Institute \u201cProf. Dr. George I.M. Georgescu\u201d, 700503 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana-Maria","family":"St\u0103tescu","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Laboratory, \u201cSf. Spiridon\u201d Emergency County Clinical Hospital Iasi, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Cri\u0219u","sequence":"additional","affiliation":[{"name":"Cardiology Department, \u201cSf. Spiridon\u201d Emergency County Clinical Hospital Iasi, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoniu Octavian","family":"Petri\u0219","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine-Cardiology, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Iasi, 700115 Iasi, Romania"},{"name":"Cardiology Department, \u201cSf. Spiridon\u201d Emergency County Clinical Hospital Iasi, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1801-9327","authenticated-orcid":false,"given":"Florin","family":"Mitu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine-Cardiology, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Iasi, 700115 Iasi, Romania"},{"name":"Cardiology Department, Clinical Recovery Hospital Iasi, 700661 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cipriana","family":"\u0218tef\u0103nescu","sequence":"additional","affiliation":[{"name":"Department of Biophysics and Medical Physics, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d Iasi, 700115 Iasi, Romania"},{"name":"Nuclear Medicine Laboratory, \u201cSf. Spiridon\u201d Emergency County Clinical Hospital Iasi, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1080\/13506129.2019.1604336","article-title":"Amyloid in parenchymal organs in gelsolin (AGel) amyloidosis","volume":"26","author":"Schmidt","year":"2019","journal-title":"Amyloid"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1016\/j.recesp.2017.05.018","article-title":"Diagnosis and Treatment of Transthyretin Cardiac Amyloidosis. Progress and Hope","volume":"70","year":"2017","journal-title":"Rev. Esp. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1016\/j.amjmed.2022.01.004","article-title":"When to Suspect and How to Approach a Diagnosis of Amyloidosis","volume":"135","author":"Law","year":"2022","journal-title":"AJM"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1146\/annurev-med-052918-020140","article-title":"Cardiac Amyloidosis: Overlooked, Underappreciated, and Treatable","volume":"71","author":"Rubin","year":"2020","journal-title":"Annu. Rev. Med."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Adam, R., Neculae, G., Stan, C., and Jurcut, R. (2021). Current Challenges of Cardiac Amyloidosis Awareness among Romanian Cardiologists. Diagnostics, 11.","DOI":"10.20944\/preprints202103.0633.v1"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"ESC Scientific Document Group. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1554","DOI":"10.1093\/eurheartj\/ehab072","article-title":"Diagnosis and treatment of cardiac amyloidosis: A position statement of the ESC Working Group on Myocardial and Pericardial Diseases","volume":"42","author":"Rapezzi","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/j.jchf.2019.04.010","article-title":"Screening for transthyretin amyloid cardiomyopathy in everyday practice","volume":"7","author":"Witteles","year":"2019","journal-title":"JACC Heart Fail."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"E142","DOI":"10.1093\/eurheartj\/suaa080","article-title":"Cardiac amyloidosis: Do not forget to look for it","volume":"22","author":"Porcari","year":"2020","journal-title":"Eur. Heart J. Suppl."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1590\/1806-9282.66.3.345","article-title":"Cardiac amyloidosis: Non-invasive diagnosis","volume":"66","author":"Hotta","year":"2020","journal-title":"Rev. Assoc. Med. Bras."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1007\/s10741-020-10062-w","article-title":"Practical recommendations for the diagnosis and management of transthyretin cardiac amyloidosis","volume":"26","author":"Bistola","year":"2021","journal-title":"Heart Fail. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Jung, M.-H., Chang, S., Han, E.J., and Youn, J.-C. (2022). Multimodal Imaging and Biomarkers in Cardiac Amyloidosis. Diagnostics, 12.","DOI":"10.3390\/diagnostics12030627"},{"key":"ref_13","first-page":"1","article-title":"Wild-type transthyretin amyloid cardiomyopathy complicated by spinal canal stenosis, carpal tunnel syndrome, and rotator cuff tears: A case report","volume":"4","author":"Takashio","year":"2020","journal-title":"ESC Heart Fail."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2845","DOI":"10.1007\/s12350-020-02152-x","article-title":"Estimation of prevalence of transthyretin (ATTR) cardiac amyloidosis in an Australian subpopulation using bone scans with echocardiography and clinical correlation","volume":"28","author":"Cuscaden","year":"2020","journal-title":"J. Nucl. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"12","DOI":"10.3949\/ccjm.84.s3.02","article-title":"Cardiac amyloidosis: An update on diagnosis and treatment","volume":"84","author":"Donnelly","year":"2017","journal-title":"Clevel. Clin. J. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.tcm.2017.07.004","article-title":"Cardiac amyloidosis: An update on pathophysiology, diagnosis and treatment","volume":"28","author":"Siddiqi","year":"2018","journal-title":"Trends Cardiovasc. Med."},{"key":"ref_17","first-page":"100519","article-title":"Diagnosing cardiac amyloidosis in every-day practice: A practical guide for the cardiologist","volume":"28","author":"Papathanasiou","year":"2020","journal-title":"Int. J. Cardiol. Heart Vasc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.hjc.2019.10.004","article-title":"Transthyretin cardiac amyloidosis in aortic stenosis: Prevalence, diagnostic challenges, and clinical implications","volume":"61","author":"Balciunaite","year":"2020","journal-title":"Hellenic. J. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e17256","DOI":"10.1097\/MD.0000000000017256","article-title":"The role of echocardiography and 99mTc- HDP scintigraphy in non-invasive diagnosis of cardiac amyloidosis: A case series and literature review","volume":"98","author":"Costache","year":"2019","journal-title":"Medicine"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1007\/s12350-018-01552-4","article-title":"State-of-the-art radionuclide imaging in cardiac transthyretin amyloidosis","volume":"26","author":"Singh","year":"2019","journal-title":"J. Nucl. Cardiol."},{"key":"ref_21","unstructured":"Castellucci, P., D\u00e9sir\u00e9e, D., Krizas\u00e1n, K.\u00c1., Mirzaei, S., Prior, J., and Sattler, B. (2021). Scintigrafia osoas\u0103. Ghid European de Medicin\u0103 Nuclear\u0103: Publica\u021bie Comun\u0103 a EANM \u0219i UEMS\/EBNM, Editura Medical\u0103 Universitar\u0103 \u201dIuliu Ha\u021beganu\u201d."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1097\/MNM.0000000000001615","article-title":"British Nuclear Medicine Society Clinical Guideline for bone scintigraphy","volume":"43","author":"Graham","year":"2022","journal-title":"Nucl. Med. Commun."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1879","DOI":"10.1007\/s12350-017-1141-3","article-title":"Cardiac ATTR amyloid nuclear imaging-not all bone scintigraphy radionuclide tracers are created equal","volume":"25","author":"Yang","year":"2018","journal-title":"J. Nucl. Cardiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1093\/ehjci\/jew325","article-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","volume":"18","author":"Hutt","year":"2017","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1007\/s12350-016-0707-9","article-title":"Early-phase myocardial uptake intensity of 99mTc-HMDP vs 99mTc-DPD in patients with hereditary transthyretin-related cardiac amyloidosis","volume":"25","author":"Abulizi","year":"2018","journal-title":"J. Nucl. Cardiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1016\/j.jacc.2005.05.073","article-title":"Noninvasive etiologic diagnosis of cardiac amyloidosis using 99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid scintigraphy","volume":"46","author":"Perugini","year":"2005","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"35","DOI":"10.3109\/13506129.2013.871250","article-title":"Bone scintigraphy with (99m) technetium-hydroxymethylene diphosphonate allows early diagnosis of cardiac involvement in patients with transthyretin-derived systemic amyloidosis","volume":"21","author":"Glaudemans","year":"2014","journal-title":"Amyloid"},{"key":"ref_28","unstructured":"Dorbala, S., Bokhari, S., Miller, E.J., Bullock Palmer, R., Soman, P., and Thompson, R. (2019). 99mTechnetium-pyrophosphate imaging for transthyretin cardiac amyloidosis. ASNC Practice Points, ASNC."},{"key":"ref_29","first-page":"e1","article-title":"ASNC\/AHA\/ASE\/EANM\/HFSA\/ISA\/SCMR\/SNMMI Expert consensus recommendations for multimodality imaging in cardiac amyloidosis: Part 1 of 2\u2014Evidence base and standardized methods of imaging","volume":"25","author":"Dorbala","year":"2019","journal-title":"J. Nucl. Cardiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1007\/s12350-019-01761-5","article-title":"ASNC\/AHA\/ASE\/EANM\/HFSA\/ISA\/SCMR\/SNMMI Expert consensus recommendations for multimodality imaging in cardiac amyloidosis: Part 2 of 2\u2014Diagnostic criteria and appropriate utilization","volume":"27","author":"Dorbala","year":"2019","journal-title":"J. Nucl. Cardiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.cpcardiol.2017.04.003","article-title":"Cardiac amyloidosis: An updated review with emphasis on diagnosis and future directions","volume":"43","author":"Bhogal","year":"2018","journal-title":"Curr. Probl. Cardiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1007\/s12471-019-1299-1","article-title":"Cardiac amyloidosis: The need for early diagnosis","volume":"27","author":"Oerlemans","year":"2019","journal-title":"Neth. Heart J."},{"key":"ref_33","first-page":"1072","article-title":"Radionuclide imaging in the diagnosis of transthyretin cardiac amyloidosis: Different sensitivity in early-onset V30M mutation?","volume":"13","author":"Rodrigues","year":"2020","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_34","first-page":"424","article-title":"Biomarkers and Prediction of Prognosis in Transthyretin-Related Cardiac Amyloidosis: Direct Comparison of Two Staging Systems","volume":"36","author":"Cappelli","year":"2020","journal-title":"CJC"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1007\/s11886-019-1180-2","article-title":"Cardiac amyloidosis: Updates in imaging","volume":"21","author":"Chacko","year":"2019","journal-title":"Curr. Cardiol. Rep."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2799","DOI":"10.1093\/eurheartj\/ehx589","article-title":"A new staging system for cardiac transthyretin amyloidosis","volume":"39","author":"Gillmore","year":"2018","journal-title":"Eur. Heart J."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/1\/83\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:53:26Z","timestamp":1760147606000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/1\/83"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,28]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["diagnostics13010083"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics13010083","relation":{},"ISSN":["2075-4418"],"issn-type":[{"type":"electronic","value":"2075-4418"}],"subject":[],"published":{"date-parts":[[2022,12,28]]}}}