<prompt> The most reliable investigation in amyloid disease is-Immunoglobulin assayUltrasoundRectal biopsyUrine examination  <response>: The best sites from which to obtain a biopsy specimen in systemic amyloidosis are the abdominal fat pad and rectal mucosa approaching 90 sensitivity for fat pad and 73-84 for rectal mucosaWhile some imaging modalities can strongly suggest amyloidosis, a tissue sample showing birefringent material is still the criterion standard.This is definitely the case in terms of cardiac-specific amyloid.While endomyocardial biopsy is the best confirmatory test for local cardiac amyloid deposition, it can be very- risk averse and requires a centre of excellence with the full complement of immunohistochemical and molecular-based testing 