Hi Skip! Great question — and it's completely understandable to want clarity while waiting for your cardiology appointment.
What is a Nuclear (PYP/Technetium) Scan?
This scan detects how much amyloid protein has deposited in your heart. It uses a radioactive tracer that "sticks" to amyloid deposits, and the results are Show Full Answer
Hi Skip! Great question — and it's completely understandable to want clarity while waiting for your cardiology appointment.
What is a Nuclear (PYP/Technetium) Scan?
This scan detects how much amyloid protein has deposited in your heart. It uses a radioactive tracer that "sticks" to amyloid deposits, and the results are graded visually and measured numerically.
What does Grade 2 mean?
The visual grading scale typically runs from 0 to 3:
- Grade 0 — No uptake (no amyloid detected)
- Grade 1 — Mild uptake, less than bone
- Grade 2 — Moderate uptake, equal to bone
- Grade 3 — Strong uptake, greater than bone
A Grade 2 result means there is a moderate level of amyloid deposit activity in your heart — enough to be clearly significant and supportive of a TTR amyloidosis diagnosis.
What does H/CL Ratio 1.5 mean?
The Heart-to-Contralateral Lung (H/CL) ratio compares tracer uptake in your heart versus your lung (which should have minimal uptake). A ratio of 1.5 means your heart is absorbing 1.5 times more tracer than the lung — this is considered a positive result, further supporting TTR amyloidosis involvement in the heart. Does this tell us your amyloidosis stage?
Unfortunately, the nuclear scan result alone doesn't determine your stage. Staging for ATTR amyloidosis is based on specific blood biomarker levels, particularly:
- NT-proBNP (a marker of heart stress) — cutoff is less than 3,000 nanograms per liter
- eGFR (a measure of kidney function) — cutoff is more than 45 milliliters per minute
Your stage is determined by how many of these markers fall outside the normal range. Without those specific lab values, it's not possible to assign a stage from the scan result alone.
What this result does tell you
Your nuclear scan result is consistent with your existing Wild-type ATTR diagnosis and suggests amyloid is actively depositing in your heart. This is important information your cardiologist will use alongside your biomarker blood tests to assess progression and guide treatment.
It's worth noting that while a month feels like a long wait (and it really is!), bringing a written list of questions to your cardiology appointment — including asking specifically about your NT-proBNP and eGFR levels — will help you get the clearest picture of where things stand.
Hang in there, Skip. You're asking exactly the right questions. 💙
June 2
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