TABLE 2.

Comparison of each imaging modality with their specific findings in cardiac amyloidosis as well as their relative strengths and weakness.

Imaging modality	Findings in cardiac amyloidosis	Strengths	Limitations
Echocardiography	LVH	Readily available	No differentiation between CA subtypes
	Small LV cavity	Cheap	Variable image quality
	Large atria	High temporal resolution	Early findings in CA non-specific
	RV/LV systolic dysfunction	Identify other causes of LVH (AS, HCM, etc.)
	Abnormal LV diastolic function	No radiation
	Abnormal strain	Patient ease
	Pericardial/pleural effusion
Magnetic resonance imaging (MRI)	Similar morphologic findings to echocardiography (Figure 2)	Reproducible	Expensive
	Late gadolinium enhancement in atria and ventricles	Direct tissue characterization	Limited availability
	Pericardial/pleural effusion	No radiation	Special expertise required
	Atria dysfunction	Identify other causes of LVH (HCM, infiltrating disease)	Multiple patient specific exclusions (implants, claustrophobia, etc.)
	Interatrial septum thickening	Higher spatial resolution and multi-dimensional strain
	Abnormal strain
Cardiac scintigraphy (PYP, DPD, and HDMP)	Increased radiotracer uptake	Cheap	Radiation
	Increased H/CL ratio	Widely available	Mostly qualitative
		Ease of interpretation	Genetic variant uptake variability
		Differentiate amyloid subtype
PET imaging	Increased radiotracer uptake	Quantitative assessment	Radiation
		Differentiate amyloid subtype	Expensive

AS, aortic stenosis; H/CL, heart/contralateral; HCM, hypertrophic cardiomyopathy; LV, left ventricle; LVH, left ventricular hypertrophy; PET, positron-emission tomography.