**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.**
Paolo Milani, Department of Molecular Medicine, University of Pavia, Amyloidosis Research and Treatment Center, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

**Main Body of the Abstract**
[18F]-Florbetaben positron emission tomography (F-PET) emerged as a promising non-invasive tool to identify and quantify cardiac involvement in AL amyloidosis and possibly discriminating it from ATTR amyloidosis or other mimicking cardiomyopathies. The MoRBiDA trial (NCT-04392960) evaluates cardiac imaging through echocardiography, magnetic resonance (MRI) and F-PET in treatment-naïve patients with AL amyloidosis at diagnosis and 6-months from treatment initiation. Here we report the first analysis of MoRBiDA, focusing on the diagnostic performance of F-PET.
A 3-dimensional list-mode dynamic 50 minutes PET acquisition of the heart started immediately after injection of a mean dose 376 (± 70 SD) MBq of florbetaben. Semi-quantitative PET parameters (SUVmean, SUVmax, Myocardial Tracer Retention) of cardiac walls were evaluated at 15/50/110 minutes after tracer administration.
Twenty-eight patients with biopsy proven AL amyloidosis and elevated NT-proBNP were enrolled. In 3 cases echocardiography, MRI and F-PET were not suggestive for AL cardiac amyloidosis while cardiac biomarkers were elevated due to previous ischemic heart disease. In 24 (86%) patients, heart involvement was confirmed by cardiac biomarkers, MRI, and echocardiography. In 21 of these subjects F-PET was also consistent with heart involvement. In the remaining 4 patients with confirmed heart involvement by echocardiography and MRI, F-PET did not show a delayed uptake compatible with AL amyloidosis (Table).
Delayed F-PET uptake can be absent in patients with AL amyloidosis and early (stage II) heart involvement. Our results suggest caution before introducing this tracer in the diagnostic workup. The role of F-PET to monitor amyloid deposits is being assessed in the MoRBiDA trial.



**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.**
Paolo Milani, Department of Molecular Medicine, University of Pavia, Amyloidosis Research and Treatment Center, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

**Main Body of the Abstract**
[18F]-Florbetaben positron emission tomography (F-PET) emerged as a promising non-invasive tool to identify and quantify cardiac involvement in AL amyloidosis and possibly discriminating it from ATTR amyloidosis or other mimicking cardiomyopathies. The MoRBiDA trial (NCT-04392960) evaluates cardiac imaging through echocardiography, magnetic resonance (MRI) and F-PET in treatment-naïve patients with AL amyloidosis at diagnosis and 6-months from treatment initiation. Here we report the first analysis of MoRBiDA, focusing on the diagnostic performance of F-PET.
A 3-dimensional list-mode dynamic 50 minutes PET acquisition of the heart started immediately after injection of a mean dose 376 (± 70 SD) MBq of florbetaben. Semi-quantitative PET parameters (SUVmean, SUVmax, Myocardial Tracer Retention) of cardiac walls were evaluated at 15/50/110 minutes after tracer administration.
Twenty-eight patients with biopsy proven AL amyloidosis and elevated NT-proBNP were enrolled.** **In 3 cases echocardiography, MRI and F-PET were not suggestive for AL cardiac amyloidosis while cardiac biomarkers were elevated due to previous ischemic heart disease. In 24 (86%) patients, heart involvement was confirmed by cardiac biomarkers, MRI, and echocardiography. In 21 of these subjects F-PET was also consistent with heart involvement. In the remaining 4 patients with confirmed heart involvement by echocardiography and MRI, F-PET did not show a delayed uptake compatible with AL amyloidosis (Table).
Delayed F-PET uptake can be absent in patients with AL amyloidosis and early (stage II) heart involvement. Our results suggest caution before introducing this tracer in the diagnostic workup. The role of F-PET to monitor amyloid deposits is being assessed in the MoRBiDA trial.



Diagnostic performance of [18F]-Florbetaben PET for the detection of cardiac involvement in AL amyloidosis: first results of the MoRBiDA trial OB2 (#444)

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.