Novel imaging techniques using 18F-florbetapir PET/MRI can guide fascicular nerve biopsy in amyloid multiple mononeuropathy

Kamal Shouman, Stephen M. Broski, Eli Muchtar, Courtney A. Pendleton, Geoffrey B. Johnson, Jennifer Tracy, Janean K. Engelstad, Robert J. Spinner, P. James B. Dyck

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Multiple mononeuropathy is a rare presentation of primary (AL) amyloidosis and nerve biopsy is usually needed for diagnosis. Conventional imaging is useful to identify proximal nerve involvement but may be inadequate. We report a patient with multiple mononeuropathy whose presentation was suggestive of AL amyloid neuropathy and in whom repeated tissue biopsies were negative for amyloid (including two sensory nerves and one muscle). Methods: The patient underwent magnetic resonance imaging (MRI) and whole body 18F-florbetapir positron emission tomography (PET)/MRI. Results: Whole body 18F-florbetapir PET/MRI revealed abnormal low-level florbetapir uptake in the right proximal tibial and peroneal nerves, which provided a target for a sciatic bifurcation fascicular nerve biopsy that was diagnostic of AL amyloidosis. Conclusions: 18F-florbetapir PET/MRI imaging is a promising diagnostic tool for patients with suspected peripheral nerve amyloidosis (including multiple mononeuropathy) in whom conventional imaging and nerve and muscle biopsies miss the pathology.

Original languageEnglish (US)
Pages (from-to)104-108
Number of pages5
JournalMuscle and Nerve
Volume63
Issue number1
DOIs
StatePublished - Jan 2021

Keywords

  • F-florbetapir PET/MRI
  • MR neurography
  • amyloidosis
  • multiple mononeuropathy
  • sural nerve biopsy

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Physiology (medical)

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