Updates on the Role of Imaging in Cardiac Amyloidosis

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Purpose of review: Imaging of cardiac amyloidosis has traditionally been hindered by nonspecific findings or diagnosis late in disease. Recent imaging techniques aim to address these gaps. Recent findings: T1 mapping, extracellular volume (ECV) quantification, myocardial strain imaging, positron emission tomography/computed tomography (PET/CT), bone-seeking agents, and cardiac computed tomography angiography (CCTA) are a few of the imaging modalities and techniques used to image cardiac amyloidosis. Many offer the possibility of earlier cardiac amyloidosis detection. PET/CT and bone-seeking agents may allow for quantification of amyloid deposition as well as treatment response monitoring. Additionally, bone-seeking agents help diagnose transthyretin amyloidosis without the need for endomyocardial biopsy. Summary: New imaging techniques have helped to expand the role of imaging in cardiac amyloidosis by offering the possibility of earlier disease detection, disease burden quantification, and cardiac amyloid subtype differentiation.