Preliminary Diagnosis: Amyloidosis
I. What imaging technique is first-line for this diagnosis?
Amyloidosis is a histological diagnosis. However, some imaging modalities may suggest amyloidosis in the correct clinical setting. A first-line imaging modality is CT imaging of the area of interest with IV and oral contrast.
II. Describe the advantages and disadvantages of this technique for diagnosis of Amyloidosis.
Advantages
- Highly sensitive and specific in detecting the surrounding soft tissues, osseous structures, and vasculature
- May suggest a focal suspicious abnormality
- May guide percutaneous biopsy and treatment
Disadvantages
- Exposes patients to ionizing radiation
- Amyloidosis is a histological diagnosis
III. What are the contraindications for the first-line imaging technique?
- May be contraindicated in pregnant patients
IV. What alternative imaging techniques are available?
- Contrasted MR imaging
- Ultrasound
V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of Amyloidosis.
Contrasted MR imaging
Advantages
- Does not expose patients to ionizing radiation
- Offers exquisite visualization of the soft tissues
Disadvantages
- Less adept in guiding percutaneous biopsy
- Limited in evaluating the surrounding osseous structures
- May be subject to motion and susceptibility weighted artifact degrading image quality
- Expensive
- Time-consuming
Ultrasound
Advantages
- Highly portable
- Does not expose patients to ionizing radiation
- May help guide percutaneous biopsy and other intervention
Disadvantages
- Offers limited evaluation of the surrounding soft tissues, osseous structures, and vasculature compared to companion CT and MR imaging
- Amyloidosis is a histological diagnosis
VI. What are the contraindications for the alternative imaging techniques?
Contrasted MR imaging
- May be contraindicated in patients with non-MR compatible hardware
Ultrasound
- No specific contraindications to ultrasound exist
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