Fig. 3.

Planar 99mTc-DPD scintigraphies of four different patients with varying degrees of cardiac radionuclide uptake: No cardiac uptake (Perugini score 0, a). Light cardiac uptake with preserved delineation of bone tissue (Perugini score 1, b). Strong cardiac uptake above that of bone tissue and increased soft-tissue uptake, particularly in the shoulder, abdominal wall, and gluteal region (Perugini score 2, c). Strong cardiac and soft-tissue uptake with no discernable bone-tissue uptake, suggesting diffuse amyloid soft-tissue infiltration (Perugini score 3, d). In case of myocardial uptake on planar scintigraphy, SPECT imaging should be performed, which allows for a detailed assessment of radionuclide distribution within the left-ventricular myocardium (e, short axis, vertical long axis, and horizontal long axis slices at the top and the corresponding polar plot at the bottom; white/yellow indicates high uptake; blue/black indicates little or no uptake)