Technetium pyrophosphate nuclear scintigraphy for cardiac amyloidosis: Imaging at 1 vs 3 hours and planar vs SPECT/CT
- PDF / 491,033 Bytes
- 6 Pages / 593.972 x 792 pts Page_size
- 17 Downloads / 168 Views
Saint Luke’s Mid America Heart Institute, Kansas City, MO University of Missouri-Kansas City, Kansas City, MO
Received Jan 4, 2020; accepted Apr 3, 2020 doi:10.1007/s12350-020-02139-8
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 1and 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. (J Nucl Cardiol 2020) Key Words: Cardiomyopathy Æ amyloid heart disease Æ heart failure Æ SPECT Æ image analysis Æ image interpretation Abbreviations ASNC American Society of Nuclear Cardiology ATTR Transthyretin cardiac amyloidosis H/CL Heart-to-contralateral lung
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12350-020-02139-8) contains supplementary material, which is available to authorized users. Funding None. The authors of this article have provided a PowerPoint file, available for download at SpringerLink, which summarizes the contents of the paper and is free for re-use at meetings and presentations. Search for the article DOI on SpringerLink.com. The authors have also
SPECT/CT TcPYP
Single photon emission tomography with computed tomography Technetium-99m pyrophosphate
provided an audio summary of the article,which is available to download as ESM, or to listen to via theJNC/ASNC Podcast. Reprint requests: Brett W. Sperry, MD, Saint Luke’s Mid America Heart Institute, 4330 Wornall Rd, Suite 2000, Kansas City, MO 64111; [email protected] 1071-3581/$34.00 Copyright Ó 2020 American Society of Nuclear Cardiology.
Sperry et al Technetium pyrophosphate nuclear scintigraphy for cardiac amyloidosis
BACKGROUND Cardiac amyloidosis is a disease in which misfolded proteins aggregate into amyloid fibrils and deposit into the heart, leading to predominantly diastolic heart failu
Data Loading...
