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Measurement of liver and spleen interstitial volume in patients with systemic amyloid light-chain amyloidosis using equilibrium contrast CT

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Abstract

Objectives

To investigate equilibrium contrast-enhanced CT (EQ-CT) measurement of extracellular volume fraction (ECV) in patients with systemic amyloid light-chain (AL) amyloidosis, testing the hypothesis that ECV becomes elevated in the liver and spleen and ECV correlates with other estimates of organ amyloid burden.

Methods

26 patients with AL amyloidosis underwent EQ-CT, and ECV was measured in the liver and spleen. Patients also underwent serum amyloid P (SAP) component scintigraphy with grading of liver and spleen involvement. Mann–Whitney U test was used to test for a difference between patients with amyloid deposition (SAP grade 1–3) and those without (SAP grade 0). Variation in ECV across SAP grades was assessed using the Kruskal–Wallis test and association between ECV and SAP grades with Spearman correlation.

Results

Mean ECV in the spleen and liver was significantly greater (p < 0.0005) in amyloidotic organs (SAP grade 1–3) [spleen, liver: 0.430, 0.375] compared with healthy tissues [spleen, liver: 0.304, 0.269]. ECV increased with increasing amyloid burden, showing positive correlation with SAP grade in both the liver (r = 0.758) and spleen (r = 0.867).

Conclusion

In patients with systemic AL amyloidosis, EQ-CT can demonstrate increased spleen and liver ECV, which is associated with amyloid disease burden.

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Abbreviations

AL amyloidosis:

Systemic amyloid light-chain amyloidosis

EQ-CT:

Equilibrium contrast-enhanced computed tomography

EQ-MRI:

Equilibrium contrast-enhanced magnetic resonance imaging

EQ-CMR:

Equilibrium contrast cardiac MRI

ECV:

Extracellular volume fraction

SAP:

Serum amyloid P

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Acknowledgements

We gratefully acknowledge the contributions of CT radiographers Elaine Atkins and Preeya Patel at University College London Hospital, David Edwards at the Royal Free Hospital, and Toshiba’s CT specialists Mark Condron and Tristan Lawton. TA Treibel and S Bandula are supported by Doctoral Research Fellowships from NIHR, UK (NIHR-DRF-2013-06-102/NIHR-DRF-2011-04-008). S Taylor is an NIHR senior investigator. The majority of this work was undertaken at University College London Hospital and University College London, which receive a proportion of funding from the NIHR Biomedical Research Centre funding scheme.

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Authors and Affiliations

  1. Centre for Medical Imaging, University College London, 250 Euston Road, London, NW1 2PG, UK

    Jason Yeung, S. Sivarajan, S. Punwani, S. A. Taylor & S. Bandula

  2. Institute of Cardiovascular Science, University College London, London, WC1E 6BT, UK

    T. A. Treibel, S. Rosmini & J. C. Moon

  3. Barts Heart Centre, St Bartholomew’s Hospital, West Smithfield, London, EC1A 7BE, UK

    T. A. Treibel & J. C. Moon

  4. National Amyloidosis Centre, University College London, Rowland Hill Street, London, NW3 2PF, UK

    M. Fontana, J. D. Gillmore & P. N. Hawkins

Authors
  1. Jason Yeung
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  2. S. Sivarajan
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  3. T. A. Treibel
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  4. S. Rosmini
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  5. M. Fontana
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  6. J. D. Gillmore
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  7. P. N. Hawkins
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  8. S. Punwani
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  9. J. C. Moon
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  10. S. A. Taylor
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  11. S. Bandula
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Corresponding author

Correspondence to Jason Yeung.

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Funding

This study has received funding from the National Amyloid Centre to cover scanning costs.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Institutional Review Board approval was obtained. All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Yeung, J., Sivarajan, S., Treibel, T.A. et al. Measurement of liver and spleen interstitial volume in patients with systemic amyloid light-chain amyloidosis using equilibrium contrast CT. Abdom Radiol 42, 2646–2651 (2017). https://doi.org/10.1007/s00261-017-1194-4

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  • DOI: https://doi.org/10.1007/s00261-017-1194-4

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