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Rosengren, Sara
Publications (4 of 4) Show all publications
Kero, T., Sorensen, J., Antoni, G., Wilking, H., Carlson, K., Vedin, O., . . . Lubberink, M. (2018). Quantification of (11)C-PIB kinetics in cardiac amyloidosis. Journal of Nuclear Cardiology, ISSN 1071-3581, EISSN 1532-6551
Open this publication in new window or tab >>Quantification of (11)C-PIB kinetics in cardiac amyloidosis
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2018 (English)In: Journal of Nuclear Cardiology, ISSN 1071-3581, EISSN 1532-6551Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: The purpose of this work was to determine the optimal tracer kinetic model of (11)C-PIB and to validate the use of the simplified methods retention index (RI) and standardized uptake value (SUV) for quantification of cardiac (11)C-PIB uptake in amyloidosis. METHODS AND RESULTS: Single-tissue, reversible and irreversible two-tissue models were fitted to data from seven cardiac amyloidosis patients who underwent (11)C-PIB PET scans and arterial blood sampling for measurement of blood radioactivity and metabolites. The irreversible two-tissue model (2Tirr) best described cardiac (11)C-PIB uptake. RI and SUV showed high correlation with the rate of irreversible binding (Ki) from the 2Tirr model (r(2 )=0.95 and r(2 )=0.94). Retrospective data from 10 amyloidosis patients and 5 healthy controls were analyzed using RI, SUV, as well as compartment modelling with a population-average metabolite correction. All measures were higher in amyloidosis patients than in healthy controls (p=.001), but with an overlap between groups for Ki. CONCLUSION: An irreversible two-tissue model best describes the (11)C-PIB uptake in cardiac amyloidosis. RI and SUV correlate well with Ki from the 2Tirr model. RI and SUV discriminate better between amyloidosis patients and controls than Ki based on population-average metabolite correction.

Keywords
11c-pib, Cardiac amyloidosis, absolute quantification, retention index, standardized uptake value
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-356695 (URN)10.1007/s12350-018-1349-x (DOI)1532-6551 (Electronic) 1071-3581 (Linking) (ISBN)
Note

Kero, Tanja Sorensen, Jens Antoni, Gunnar Wilking, Helena Carlson, Kristina Vedin, Ola Rosengren, Sara Wikstrom, Gerhard Lubberink, Mark eng J Nucl Cardiol. 2018 Jul 23. pii: 10.1007/s12350-018-1349-x. doi: 10.1007/s12350-018-1349-x.

Available from: 2018-08-03 Created: 2018-08-03 Last updated: 2018-10-25Bibliographically approved
Rosengren, S., Mellqvist, U.-H., Nahi, H., Forsberg, K., Lenhoff, S., Strömberg, O., . . . Carlson, K. (2016). Outcome of AL amyloidosis after high-dose melphalan and autologous stem cell transplantation in Sweden, long-term results from all patients treated in 1994-2009.. Bone Marrow Transplantation, 51(12), 1569-1572
Open this publication in new window or tab >>Outcome of AL amyloidosis after high-dose melphalan and autologous stem cell transplantation in Sweden, long-term results from all patients treated in 1994-2009.
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2016 (English)In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 51, no 12, p. 1569-1572Article in journal (Refereed) Published
Abstract [en]

High-dose melphalan and autologous stem cell transplantation (HDM/ASCT) is widely used in immunoglobulin light chain (AL) amyloidosis, but the benefit is debated mainly because of the high treatment-related mortality (24% in a randomised study comparing HDM/ASCT with oral melphalan/dexamethasone). We report here on the long-term outcome of all patients treated with HDM/ASCT for AL amyloidosis in Sweden between 1994 and 2009. Seventy-two patients were treated at eight Swedish centres. Median follow-up was 67.5 months. At least partial response (organ or haematological) was seen in 64% of the patients. Median overall survival was 98 months or 8.2 years, with 5-year survival 63.9% and 10-year survival 43.4%. In patients with cardiac involvement or multiple organ involvement, survival was significantly shorter, median overall survival 49 and 56 months, respectively. All mortality within 100 days from ASCT was 12.5% for all patients and 17.2% in the patients with cardiac involvement. For patients treated in the earlier time period (1994-2001), 100-day mortality was 23.8% compared with 7.8% in the later period (2002-2009). In conclusion, long survival times can be achieved in patients with AL amyloidosis treated with HDM/ASCT, also in smaller centres. Early mortality is high, but with a decreasing trend over time.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-310948 (URN)10.1038/bmt.2016.249 (DOI)000390759600005 ()27694943 (PubMedID)
Available from: 2016-12-20 Created: 2016-12-20 Last updated: 2017-11-29Bibliographically approved
Granstam, S.-O., Rosengren, S., Vedin, O., Kero, T., Sörensen, J., Carlson, K., . . . Wikström, G. (2013). Evaluation of patients with cardiac amyloidosis using echocardiography, ECG and right heart catheterization. Amyloid: Journal of Protein Folding Disorders, 20(1), 27-33
Open this publication in new window or tab >>Evaluation of patients with cardiac amyloidosis using echocardiography, ECG and right heart catheterization
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2013 (English)In: Amyloid: Journal of Protein Folding Disorders, ISSN 1350-6129, E-ISSN 1744-2818, Vol. 20, no 1, p. 27-33Article in journal (Refereed) Published
Abstract [en]

Aims:

To characterize patients with cardiac amyloidosis using echocardiography, electrocardiogram (ECG) and right heart catheterization (RHC).

Methods and results:

Fourteen patients with biopsy verified light chain or transthyretin cardiac amyloidosis were included. All patients had heart failure with markedly elevated NT-proBNP. Echocardiography demonstrated biventricular hypertrophy, left atrial enlargement and normal to slightly reduced left ventricular ejection fraction. Tissue Doppler septal e´ was low and median E/e´ was high. Within 6 months RHC was performed in eight of the patients. The restrictive filling pattern demonstrated by echocardiography corresponded well to median pulmonary wedge pressure (21 mmHg). Systolic pulmonary artery pressure (SPAP) was increased, whereas cardiac output and stroke volume were seen to be decreased with both methods. ECG demonstrated: low voltage (36%), abnormal R-progression (65%), ST-T abnormalities (71%) and high incidence of fibrillation (36%). In addition, a case report following the treatment of melphalan and dexamethasone is presented with improvement of hypertrophy, SPAP, left ventricular mass and e´.

Conclusion:

These findings should lead to a suspicion of cardiac amyloidosis and suggest further investigation.

National Category
Medical and Health Sciences
Research subject
Cardiology
Identifiers
urn:nbn:se:uu:diva-196246 (URN)10.3109/13506129.2012.761967 (DOI)000315187100005 ()23339421 (PubMedID)
Available from: 2013-03-06 Created: 2013-03-06 Last updated: 2017-12-06Bibliographically approved
Antoni, G., Lubberink, M., Estrada, S., Axelsson, J., Carlson, K., Lindsjö, L., . . . Sörensen, J. (2013). In Vivo Visualization of Amyloid Deposits in the Heart with 11C-PIB and PET. Journal of Nuclear Medicine, 54(2), 213-220
Open this publication in new window or tab >>In Vivo Visualization of Amyloid Deposits in the Heart with 11C-PIB and PET
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2013 (English)In: Journal of Nuclear Medicine, ISSN 0161-5505, E-ISSN 1535-5667, Vol. 54, no 2, p. 213-220Article in journal (Refereed) Published
Abstract [en]

Cardiac amyloidosis is a differential diagnosis in heart failure and is associated with high mortality. There is currently no noninvasive imaging test available for specific diagnosis. N-[methyl-11C]2-(4′-methylamino-phenyl)-6-hydroxybenzothiazole (11C-PIB) PET is used in the evaluation of brain amyloidosis. We evaluated the potential use of 11C-PIB PET in systemic amyloidosis affecting the heart.

Methods:

Patients (n = 10) diagnosed with systemic amyloidosis—including heart involvement of either monoclonal immunoglobulin light-chain (AL) or transthyretin (ATTR) type—and healthy volunteers (n = 5) were investigated with PET/CT using 11C-PIB to study cardiac amyloid deposits and with 11C-acetate to measure myocardial blood flow to study the impact of global and regional perfusion on PIB retention.

Results:

Myocardial 11C-PIB uptake was visually evident in all patients 15–25 min after injection and was not seen in any volunteer. A significant difference in 11C-PIB retention in the heart between patients and healthy controls was found. The data indicate that myocardial amyloid deposits in patients diagnosed with systemic amyloidosis could be visualized with 11C-PIB. No correlation between 11C-PIB retention index and myocardial blood flow as measured with 11C-acetate was found on the global level, whereas a positive correlation on the segmental level was seen in a single patient.

Conclusion:

11C-PIB and PET could be a method to study systemic amyloidosis of type AL and ATTR affecting the heart and should be investigated further both as a diagnostic tool and as a noninvasive method for treatment follow-up.

National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-189479 (URN)10.2967/jnumed.111.102053 (DOI)000314691200021 ()23238792 (PubMedID)
Available from: 2013-01-02 Created: 2013-01-02 Last updated: 2017-12-06Bibliographically approved
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