**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Jahanzaib Khwaja, University College London Hospital, London

**Main Body of the Abstract**
Introduction:
Cardiac involvement is common in systemic AL and the most critical prognostic factor predicting poor survival. Standard non-invasive imaging of the myocardium includes echocardiogram and cardiac MRI, however case reports describe cardiac inflammation demonstrated with 18F-FDG PET/CT. We investigated the utility of inflammatory protocoled 18F-FDG PET/CT (undertaken after 18 hours of low carbohydrate diet) to detect myocardial inflammatory light chain proteotoxicity in AL amyloidosis.
Methods:
Patients undergoing 18F-FDG PET/CT with the ‘inflammatory’ protocol at diagnosis and at 6-month follow up with a diagnosis of systemic AL amyloidosis at University College London Hospitals were reviewed.
Results:
Fifteen patients (10 male, 5 female) underwent 18F-FDG PET/CT between 2021-2023. Age at diagnosis was 68 years (range 53-78), Mayo stages were stage II, IIIA, IIIB in 1, 9 and 5, respectively. At a median follow up 20 months (range 1-24), 5 patients died (4 stage IIIB; 1 stage IIIA) during follow-up at a median of 8 months (range 1-18) from diagnosis.
Baseline scan at diagnosis demonstrated myocardial uptake that was homogenous (n=5), heterogenous (n=9) patchy or no uptake (n=1). Six-month follow-up scans were performed in 11 patients: 5 improved, 4 worsening, 2 stable uptake. 2/4 with worsening uptake died after 6-month scanning. 3 patients died prior to this time point and one patient is awaiting a scan.
Conclusion:
Patients with systemic AL amyloidosis with cardiac involvement demonstrate features of inflammation by 18F-FDG PET/CT. Worsening uptake and new, patchy increased metabolic activity particularly within the left ventricle may suggest worsening cardiac inflammation and outcome.



**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Jahanzaib Khwaja, University College London Hospital, London

**Main Body of the Abstract**
**Introduction:**
Cardiac involvement is common in systemic AL and the most critical prognostic factor predicting poor survival. Standard non-invasive imaging of the myocardium includes echocardiogram and cardiac MRI, however case reports describe cardiac inflammation demonstrated with 18F-FDG PET/CT. We investigated the utility of inflammatory protocoled 18F-FDG PET/CT (undertaken after 18 hours of low carbohydrate diet) to detect myocardial inflammatory light chain proteotoxicity in AL amyloidosis.
**Methods:**
Patients undergoing 18F-FDG PET/CT with the ‘inflammatory’ protocol at diagnosis and at 6-month follow up with a diagnosis of systemic AL amyloidosis at University College London Hospitals were reviewed.
**Results:**
Fifteen patients (10 male, 5 female) underwent 18F-FDG PET/CT between 2021-2023. Age at diagnosis was 68 years (range 53-78), Mayo stages were stage II, IIIA, IIIB in 1, 9 and 5, respectively. At a median follow up 20 months (range 1-24), 5 patients died (4 stage IIIB; 1 stage IIIA) during follow-up at a median of 8 months (range 1-18) from diagnosis.
Baseline scan at diagnosis demonstrated myocardial uptake that was homogenous (n=5), heterogenous (n=9) patchy or no uptake (n=1). Six-month follow-up scans were performed in 11 patients: 5 improved, 4 worsening, 2 stable uptake. 2/4 with worsening uptake died after 6-month scanning. 3 patients died prior to this time point and one patient is awaiting a scan.
**Conclusion:**
Patients with systemic AL amyloidosis with cardiac involvement demonstrate features of inflammation by 18F-FDG PET/CT. Worsening uptake and new, patchy increased metabolic activity particularly within the left ventricle may suggest worsening cardiac inflammation and outcome.



Utility of 18F-PET Scintigraphy to detect inflammatory light chain proteotoxicity in cardiac AL amyloidosis  OB6 (#383)

We invite you to attend the XIX International Symposium on Amyloidosis to be held in Rochester, MN.

This symposium is organized as a hybrid meeting (with the focus on in-person) held from Sunday, May 26 through Thursday, May 30, 2024.

Together with the ISA Board and members of Mayo Clinic, a very attractive scientific hybrid program is being planned. The program will cover a variety of types of systemic amyloidosis: ATTR (hereditary and wild-type), AL (light-chain), AA and less frequent forms. There will be key lectures, specific symposia including those company sponsored, oral presentations and poster sessions of accepted abstracts.

COURSE DESCRIPTION
This program will provide a comprehensive review of state-of-the-art education in systemic amyloidosis: basic science, pathophysiology, diagnosis, current and emerging treatments. Scientific presentations will include competitive oral and poster abstracts. The rapid evolution of scientific discovery and expanding treatment options has created tremendous interest in the field and this meeting will fill and important gap in educating scientists and clinicians.