SAP scan images showing progression of AL amyloidosis kidney and liver involvement following chemotherapy

A SAP scan is a type of nuclear medicine imaging test which uses iodine-123 (123I) and serum amyloid P component (SAP) to diagnose amyloidosis.[1][2]

In patients with amyloidosis, large deposits of SAP coat the affected organs, in addition to the low levels normally found in the blood stream.[3] The injected 123I-SAP localises specifically to amyloid deposits, showing up as hot spots in the image.[4]

Procedure

The radiopharmaceutical is injected into the patient, with imaging taking place on a gamma camera 6-24 hours later.[3] An early blood-pool image provides a baseline for comparison with the organ SAP uptake after 24 hours.[4]

Availability

Europe

123I-SAP was granted orphan designation by the European Medicines Agency in 2003, however this was withdrawn in 2016.[5]

SAP scanning is only carried out at two European centres; in the United Kingdom from the National Amyloidosis Centre, based at the Royal Free Hospital,[6] and in the Netherlands at University Medical Center Groningen.[7]

North America

SAP scanning is not approved in the United States due to its use of human blood products.[7]

See also

References

  1. ^ Lass, Piotr (2014). "Nuclear imaging of amyloidosis". Polish Journal of Radiology. 79: 222–227. doi:10.12659/PJR.890147. PMC 4111651.
  2. ^ Sachchithanantham, S.; Wechalekar, A. D. (29 July 2013). "Imaging in systemic amyloidosis". British Medical Bulletin. 107 (1): 41–56. doi:10.1093/bmb/ldt021. PMID 23896486.
  3. ^ a b "The SAP scan (AL amyloidosis)". Myeloma UK. Retrieved 28 July 2019.
  4. ^ a b Sachchithanantham, S.; Wechalekar, A. D. (29 July 2013). "Imaging in systemic amyloidosis". British Medical Bulletin. 107 (1): 41–56. doi:10.1093/bmb/ldt021. PMID 23896486.
  5. ^ "EU/3/03/134 - Iodine (123I) Serum Amyloid P". European Medicines Agency. 17 September 2018. Retrieved 28 June 2019.
  6. ^ "NHS STANDARD CONTRACT FOR DIAGNOSTIC SERVICE FOR AMYLOIDOSIS" (PDF). NHS England. 2013. Retrieved 28 June 2019.
  7. ^ a b Noordzij, Walter; Glaudemans, Andor W. J. M.; Slart, Riemer H. J. A.; Dierckx, Rudi A.; Hazenberg, Bouke P. C. (22 August 2012). "Clinical use of differential nuclear medicine modalities in patients with ATTR amyloidosis". Amyloid. 19 (4): 208–211. doi:10.3109/13506129.2012.717993. PMID 17504868.
Categories