From the Research
Technetium pyrophosphate scans are generally considered safe, with the primary risk being radiation exposure, which is relatively low, and the benefits typically outweighing the risks for appropriately selected patients, particularly for conditions like transthyretin cardiac amyloidosis 1. The risks associated with Technetium pyrophosphate scans include:
- Radiation exposure, with a dose typically around 3-5 mSv, which is relatively low compared to other imaging studies 1
- Allergic reactions to the radiotracer, ranging from mild skin reactions to more severe anaphylaxis in extremely rare cases
- Discomfort or bruising at the injection site
- Small risk of infection whenever intravenous access is established
- Concerns about clearance of the radiotracer in patients with kidney dysfunction, though technetium compounds generally have favorable renal profiles compared to other contrast agents
- Potential fetal radiation exposure in pregnant women, who should avoid this scan when possible
- False positive results in certain conditions like recent myocardial infarction, cardiac contusion, or cardiac amyloidosis, potentially leading to diagnostic confusion Despite these risks, the TcPYP scan provides valuable diagnostic information, particularly for conditions like transthyretin cardiac amyloidosis, and is considered a useful tool in the diagnosis of this condition, with high sensitivity and specificity 2. It is worth noting that the utility of 99m Tc-labelled bone radiotracer scintigraphy for the early diagnosis of transthyretin amyloid cardiomyopathy has been recognized, and this diagnostic modality is now an integral part of disease diagnostic algorithms 2. In terms of specific patient populations, 99m Tc-labelled bone radiotracer scintigraphy may be considered in patients with a family history of the hereditary type of disease, elderly patients with unexplained cardiac findings, and patients with cardiac hypertrophy associated with diastolic dysfunction, right ventricular/interatrial septum/valve thickness, left ventricular sparkling, or apical sparing 2.