The Reading Room Podcast: Can the PET/CT Agent 124I-Evuzamitide Have an Impact in Detecting Cardiac Amyloidosis?

Emerging research suggests that use of the PET/CT radiotracer ¹²⁴I-evuzamitide may simplify testing for cardiac amyloidosis in the future.

In a recent Reading Room podcast, Sharmila Dorbala, MD, MPH, noted that the ¹²⁴I-evuzamitide agent had a 94 percent negative predictive value (NPV) for cardiac amyloidosis in the multicenter REVEAL study, which was recently published in the Journal of the American Medical Association (JAMA).¹

“ … What this is going to do, I think, is change the field from going into clinical history (and) imaging with echo or MRI free light chain studies and multiple testings to one single test, which could potentially tell the doctor this patient is amyloid yes (or) amyloid no, and that could be a big game changer I think,” noted Dr. Dorbala, the lead author of the study and the director of nuclear cardiology at the Brigham and Women’s Hospital in Boston.

For the REVEAL study, researchers reviewed data from PET/CT imaging obtained three to five hours after administration of ¹²⁴I- evuzamitide for 170 patients (median age of 72) suspected of having cardiac amyloidosis.

The study authors found that overall sensitivity and specificity for¹²⁴I- evuzamitide were 94 percent and 86 percent respectively. For patients with the transthyretin amyloidosis (ATTR) subtype, the researchers noted a 96 percent sensitivity rate and an 86 percent specificity rate. For patients with the amyloid light-chain (AL) subtype, ¹²⁴I- evuzamitide offered 95 percent sensitivity and 86 percent specificity, according to the study.

Dr. Dorbala suggested that the capability of ¹²⁴I-evuzamitide to facilitate direct visualization of amyloid disease pathology may lead to new pathways in the evaluation and monitoring of people at high risk for cardiac amyloidosis.

“In those patients, we could perform active surveillance using a tracer such as this, and this could enable us to detect very early amyloid deposits potentially before onset of symptoms or organ dysfunction. I think the exciting part of having something like this is that you could look at a future where you could design therapies to prevent organ dysfunction from amyloidosis. Prevention is a possibility if you can detect the disease early before there's organ dysfunction so that's why it's exciting on many fronts,” emphasized Dr. Dorbala, a professor of radiology at Harvard Medical School.

For more insights from Dr. Dorbala listen below or subscribe on your favorite podcast platform.

Reference

1. Dorbala S, Maurer MS, Cuddy SAM, et al. 124I-evuzamitide positron emission tomography/computed tomography for diagnosing cardiac amyloidosis: the REVEAL nonrandomized clinical trial. JAMA. 2026 Aug 30. doi: 10.1001/jama.2026.17361. Online ahead of print.