Brett W Sperry1,2, Eric Burgett3, Kevin A Bybee3,4, A Iain McGhie3,4, James H O'Keefe3,4, Ibrahim M Saeed3,4, Randall C Thompson3,4, Timothy M Bateman3,4. 1. Saint Luke's Mid America Heart Institute, 4330 Wornall Rd, Suite 2000, Kansas City, MO, 64111, USA. bsperry@saintlukeskc.org. 2. University of Missouri-Kansas City, Kansas City, MO, USA. bsperry@saintlukeskc.org. 3. Saint Luke's Mid America Heart Institute, 4330 Wornall Rd, Suite 2000, Kansas City, MO, 64111, USA. 4. University of Missouri-Kansas City, Kansas City, MO, USA.
Abstract
BACKGROUND: Multi-societal consensus recommendations endorse both planar and single photon emission tomographic (SPECT) image acquisitions for the evaluation of cardiac amyloidosis. However, the correlation between planar and SPECT findings and the optimal timing of image acquisitions remain uncertain. METHODS: This is an analysis of 109 consecutive patients who underwent technetium pyrophosphate nuclear scintigraphy for the evaluation of cardiac amyloidosis. Patients were imaged at 1 and 3 hours after radiotracer injection using both planar and SPECT/CT, and the correlations between imaging protocols were compared. RESULTS: In the overall cohort (median age 77 years, 75% male), 33 patients had radiotracer localized to the myocardium on SPECT/CT images. There was strong correlation between 1- and 3-hour planar heart-to-contralateral lung ratios (mean difference 0.07, r = 0.94). However, there was discordance between planar image interpretation (based upon semiquantitative score and H/CL ratio) and myocardial localization of radiotracer on SPECT/CT in 17 patients (16%). The pattern of SPECT/CT uptake was identical at 1 and 3 hours in all cases (32 diffuse, 1 focal). CONCLUSION: These data support the recommendation that SPECT/CT should be obtained in addition to planar images when performing nuclear scintigraphy for the detection of cardiac amyloidosis. A 1-hour planar and SPECT/CT protocol appears optimal.
BACKGROUND: Multi-societal consensus recommendations endorse both planar and single photon emission tomographic (SPECT) image acquisitions for the evaluation of cardiac amyloidosis. However, the correlation between planar and SPECT findings and the optimal timing of image acquisitions remain uncertain. METHODS: This is an analysis of 109 consecutive patients who underwent technetium pyrophosphate nuclear scintigraphy for the evaluation of cardiac amyloidosis. Patients were imaged at 1 and 3 hours after radiotracer injection using both planar and SPECT/CT, and the correlations between imaging protocols were compared. RESULTS: In the overall cohort (median age 77 years, 75% male), 33 patients had radiotracer localized to the myocardium on SPECT/CT images. There was strong correlation between 1- and 3-hour planar heart-to-contralateral lung ratios (mean difference 0.07, r = 0.94). However, there was discordance between planar image interpretation (based upon semiquantitative score and H/CL ratio) and myocardial localization of radiotracer on SPECT/CT in 17 patients (16%). The pattern of SPECT/CT uptake was identical at 1 and 3 hours in all cases (32 diffuse, 1 focal). CONCLUSION: These data support the recommendation that SPECT/CT should be obtained in addition to planar images when performing nuclear scintigraphy for the detection of cardiac amyloidosis. A 1-hour planar and SPECT/CT protocol appears optimal.
Authors: Golnaz Roshankar; Geneva C White; Sebastien Cadet; Nowell M Fine; Denise Chan; James A White; Victor Jimenez-Zepeda; Piotr J Slomka; Robert J H Miller Journal: J Nucl Cardiol Date: 2021-10-03 Impact factor: 3.872
Authors: Timothy J Poterucha; Pierre Elias; Sabahat Bokhari; Andrew J Einstein; Albert DeLuca; Mona Kinkhabwala; Lynne L Johnson; Kathleen R Flaherty; Sunil E Saith; Jan M Griffin; Adler Perotte; Mathew S Maurer Journal: JACC Cardiovasc Imaging Date: 2020-11-18
Authors: Teodor M Ionescu; Wael Jalloul; Cati R Stolniceanu; Roxana Iacob; Laura P Grecu; Ana-Maria Stătescu; Irena Grierosu; Mihai Guțu; Adrian Gavrilescu; Crișu Daniela; Antoniu Petriș; Manuela Ciocoiu; Cristina Ungureanu; Cipriana Ștefănescu Journal: Ann Nucl Med Date: 2021-07-17 Impact factor: 2.668