Quantitative single photon emission computed tomography derived standardized uptake values on 99mTc-PYP scan in patients with suspected ATTR cardiac amyloidosis

Avalon, Juan Carlo; Fuqua, Jacob; Deskins, Seth J; Miller, Ted R.; Conte, Justin; Martín, Daniel; Marano, Gary; Yanamala, Naveena; Mills, James K.; Bianco, Christopher; Patel, Brijesh; Seetharam, Karthik; Raylman, Raymond R.; Sengupta, Partho P.; Hamirani, Yasmin S.

doi:10.1007/s12350-022-02988-5

Cited by 8 publications

(9 citation statements)

References 24 publications

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“…In this issue of the Journal, Avalon et al evaluated the correlation of SPECT/CT standard uptake values (SUVs) with Perugini score and H/CL ratio and also assessed SUV correlation with cardiac magnetic resonance (CMR), echocardiographic, and baseline clinical characteristics. 6 The authors evaluated 78 patients with suspected ATTR-CA that underwent 99mTc-PYP scintigraphy with SPECT/CT. Patients were grouped off Perugini score (Grade 0-1 and Grade 2-3) and H/CL ratio (C 1.5 and \ 1.5).…”

mentioning

confidence: 99%

Quantitation in ATTR cardiac amyloidosis: the next step is almost there!

Grossman

2023

Journal of Nuclear Cardiology

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confidence: 99%

Quantitation in ATTR cardiac amyloidosis: the next step is almost there!

Grossman

2023

Journal of Nuclear Cardiology

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“… 32 A close correlation has been determined between ECV and myocardial 99m Tc-PYP SUVmax at 1 hour corrected for blood pool ( r 2 = .83, P = .001, n = 9). 12 The diagnostic ability of 99m Tc-PYP three-dimensional SPECT is comparable between 1 and 3 hours. 33 – 35 Delayed acquisition has been reported as a cause of false-negative diagnoses of ATTR-CM.…”

Section: Discussionmentioning

confidence: 92%

Transthyretin amyloid cardiomyopathy disease burden quantified using 99mTc-pyrophosphate SPECT/CT: volumetric parameters versus SUVmax ratio at 1 and 3 hours

Watanabe,

Nakajima,

Toshima

et al. 2023

Journal of Nuclear Cardiology

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Background Various parameters derived from technetium-99m pyrophosphate (99mTc-PYP) single-photon emission computed tomography (SPECT) correlate with the severity of transthyretin amyloid cardiomyopathy (ATTR-CM). However, the optimal metrics and image acquisition timing required to quantify the disease burden remain uncertain. Methods and results We retrospectively evaluated 99mTc-PYP SPECT/CT images of 23 patients diagnosed with ATTR-CM using endomyocardial biopsies and/or gene tests. All patients were assessed by SPECT/CT 1 hour after 99mTc-PYP injection, and 13 of them were also assessed at 3 hours. We quantified 99mTc-PYP uptake using the volumetric parameters, cardiac PYP volume (CPV) and cardiac PYP activity (CPA). We also calculated the SUVmax ratios of myocardial SUVmax/blood pool SUVmax, myocardial SUVmax/bone SUVmax, and the SUVmax retention index. We assessed the correlations between uptake parameters and the four functional parameters associated with prognosis, namely left ventricular ejection fraction, global longitudinal strain, myocardial extracellular volume, and troponin T. CPV and CPA correlated more closely than the SUVmax ratios with the four prognostic factors. Significant correlations between volumetric parameters and prognostic factors were equivalent between 1 and 3 hours. Conclusions The disease burden of ATTR-CM was quantified more accurately by volumetric evaluation of 99mTc-PYP SPECT/CT than SUVmax ratios and the performance was equivalent between 1 and 3 hours.

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“…Regarding the quantitative SPECT/CT parameters chosen by each investigative group and considering the software used for quantitation, numerous parameters were The standard of references for cardiac uptake, used unanimously (100%), was the Perugini score, aided or not by other semiquantitative planar indices. Four studies, Scully et al [36], Wollenweber et al [37], Ren et al [38] and Avalon et al [42], included the heart-to-contralateral lung ratio (H/CL) in their analysis of the correlation of planar scintigraphy to SPECT/CT parameters, while Wollenweber et al [37] and Ren et al [38] also analyzed the connection of heart-to-whole body ratio (H/WB) to SPECT results.…”

Section: Resultsmentioning

confidence: 99%

“…The studies that did not analyse SUV max were Scully et al [36] and Wollenweber et al [37], who chose to measure SUV peak as their main SPECT parameter. Other frequent SPECT parameters used to describe cardiac uptake in cardiac ATTR were SUV mean [38,39,42], ID [35,39] and cardiac SUV retention index [36,42]. measured throughout the studies, normalized or not to other healthy tissue uptake, with the most consistent being SUVmax, analysed in 8 papers (Figure 4).…”

Section: Resultsmentioning

confidence: 99%

Quantitative SPECT/CT Parameters in the Assessment of Transthyretin Cardiac Amyloidosis—A New Dimension of Molecular Imaging

Gherghe,

Lazar,

Sterea

et al. 2023

JCDD

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Aims: Cardiac transthyretin amyloidosis (ATTR) represents the accumulation of misfolded transthyretin in the heart interstitium. Planar scintigraphy with bone-seeking tracers has long been established as one of the three main steps in the non-invasive diagnosis of ATTR, but lately, single-photon emission computed tomography (SPECT) has gained wide recognition for its abilities to exclude false positive results and offer a possibility for amyloid burden quantitation. We performed a systematic review of the existing literature to provide an overview of the available SPECT-based parameters and their diagnostic performances in the assessment of cardiac ATTR. Methods and Methods: Among the 43 papers initially identified, 27 articles were screened for eligibility and 10 met the inclusion criteria. We summarised the available literature based on radiotracer, SPECT acquisition protocol, analysed parameters and their correlation to planar semi-quantitative indices. Results: Ten articles provided accurate details about SPECT-derived parameters in cardiac ATTR and their diagnostic potential. Five studies performed phantom studies for accurate calibration of the gamma cameras. All papers described good correlation of quantitative parameters to the Perugini grading system. Conclusions: Despite little published literature on quantitative SPECT in the assessment of cardiac ATTR, this method offers good prospects in the appraisal of cardiac amyloid burden and treatment monitoring.

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Quantitative single photon emission computed tomography derived standardized uptake values on 99mTc-PYP scan in patients with suspected ATTR cardiac amyloidosis

Cited by 8 publications

References 24 publications

Quantitation in ATTR cardiac amyloidosis: the next step is almost there!

Quantitation in ATTR cardiac amyloidosis: the next step is almost there!

Transthyretin amyloid cardiomyopathy disease burden quantified using 99mTc-pyrophosphate SPECT/CT: volumetric parameters versus SUVmax ratio at 1 and 3 hours

Quantitative SPECT/CT Parameters in the Assessment of Transthyretin Cardiac Amyloidosis—A New Dimension of Molecular Imaging

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