Claudine Régis1,2, François Harel2, Patrick Martineau3,4, Jean Grégoire2, Gad Abikhzer5, Daniel Juneau1,6, Matthieu Pelletier-Galarneau7,8. 1. Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montreal, QC, Canada. 2. Department of Medical Imaging, Institut de Cardiologie de Montreal, 5000, Bélanger, Montreal, QC, H1T1C8, Canada. 3. Department of Radiology, University of Manitoba, Winnipeg, MB, Canada. 4. BC Cancer Agency, Vancouver, BC, Canada. 5. Department of Radiology and Nuclear Medicine, Jewish General Hospital, Montreal, QC, Canada. 6. University of Ottawa Heart Institute, Ottawa, ON, Canada. 7. Department of Medical Imaging, Institut de Cardiologie de Montreal, 5000, Bélanger, Montreal, QC, H1T1C8, Canada. mattgalarneau@gmail.com. 8. Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. mattgalarneau@gmail.com.
Abstract
BACKGROUND: ATTR cardiac amyloidosis (CA) can be diagnosed with Tc-99m-PYP scintigraphy. There are two recommended interpretative approaches: the quantitative heart-to-contralateral lung ratio (H/CL) at 1 hour and the semi-quantitative visual system at 3 hours. This study's aim was to compare both approaches and to apply the semi-quantitative method at 1 hour. METHODS: Tc-99m-PYP scans of 122 consecutive subjects were reviewed using both approaches. On 1 hour planar images, regions of interest were drawn over the heart and contralateral chest to determine H/CL. Myocardial uptake was graded on 1 and 3 hour SPECT images according to the semi-quantitative method. Concordance was examined using kappa statistics. RESULTS: 31, 10, and 81 studies were positive, negative, and equivocal, respectively, for ATTR-CA using the H/CL approach. Using the grading system, 35, 77, and 10 scans were positive, negative, and equivocal, respectively. The quantitative approach led to a significantly higher proportion of equivocal studies compared to the semi-quantitative approach (P < .0001). These approaches yielded discordant results in 2 subjects; biopsy results were concordant with SPECT grade. 1 and 3 hour SPECT grades provided concordant result in 99% of cases. CONCLUSIONS: The H/CL approach resulted in a high proportion of equivocal studies. Using SPECT imaging, the semi-quantitative approach minimized this proportion and showed high concordance at 1 and 3 hours.
BACKGROUND:ATTRcardiac amyloidosis (CA) can be diagnosed with Tc-99m-PYP scintigraphy. There are two recommended interpretative approaches: the quantitative heart-to-contralateral lung ratio (H/CL) at 1 hour and the semi-quantitative visual system at 3 hours. This study's aim was to compare both approaches and to apply the semi-quantitative method at 1 hour. METHODS:Tc-99m-PYP scans of 122 consecutive subjects were reviewed using both approaches. On 1 hour planar images, regions of interest were drawn over the heart and contralateral chest to determine H/CL. Myocardial uptake was graded on 1 and 3 hour SPECT images according to the semi-quantitative method. Concordance was examined using kappa statistics. RESULTS: 31, 10, and 81 studies were positive, negative, and equivocal, respectively, for ATTR-CA using the H/CL approach. Using the grading system, 35, 77, and 10 scans were positive, negative, and equivocal, respectively. The quantitative approach led to a significantly higher proportion of equivocal studies compared to the semi-quantitative approach (P < .0001). These approaches yielded discordant results in 2 subjects; biopsy results were concordant with SPECT grade. 1 and 3 hour SPECT grades provided concordant result in 99% of cases. CONCLUSIONS: The H/CL approach resulted in a high proportion of equivocal studies. Using SPECT imaging, the semi-quantitative approach minimized this proportion and showed high concordance at 1 and 3 hours.
Authors: Brett W Sperry; Timothy M Bateman; Esma A Akin; Paco E Bravo; Wengen Chen; Vasken Dilsizian; Fabien Hyafil; Yiu Ming Khor; Robert J H Miller; Riemer H J A Slart; Piotr Slomka; Hein Verberne; Edward J Miller; Chi Liu Journal: J Nucl Cardiol Date: 2022-07-21 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