Absolute quantitative analysis of cardiac amyloidosis using SPECT/CT with 99mTc-pyrophosphate
Absolute quantitative analysis of cardiac amyloidosis using SPECT/CT with 99mTc-pyrophosphate
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使用 SPECT/CT 使用 99mTc-焦磷酸盐对心脏淀粉样变性进行绝对定量分析
DOI：
10.1080/13506129.2021.1903418
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发表时间：
2021
期刊：
影响因子：
5.5
通讯作者：
Yoshiki Sekijima
中科院分区：
文献类型：
--
作者：
Shin Yanagisawa;Yusuke Takahashi;Jun Sasaki;Ken Takasone;Koji Yoshie;Jun Koyama;Nagaaki Katohi;Masahide Yazaki;Koichiro Kuwahara;Yasunari Fujinaga;Yoshiki Sekijima
骨显像在心脏淀粉样变的诊断中的作用越来越重要。在放射性核素成像中，使用平面图像进行半定量评价，即视觉评分系统（VSP）和心脏与对侧（H/CL）比值，已用于分析心脏淀粉样蛋白积聚。尽管这些半定量方法对于诊断心脏淀粉样变性是有用的，但是它们不适合于评估疾病进展和治疗效果，因为它们不能检测到小的变化。本研究使用免费提供的供应商中立软件程序（GI-BONE;阿泽，日本东京），对经肌内膜活检证实的淀粉样变性患者进行了99 mTc-焦磷酸盐（PYP）断层扫描的绝对定量评价。对12例连续肌内膜活检证实的淀粉样变性患者和1例非淀粉样变性患者进行了99 mTc-PYP单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）图像分析。定量心肌99 mTc-PYP蓄积，并使用GI-BONE计算标准化摄取值（SUV）max、SUV峰值和SUV平均值，以与VSP和H/CL比值结果进行比较。心脏示踪剂摄取和活检心肌标本中的组织病理学淀粉样蛋白浸润之间的相关性也进行了研究。患者的淀粉样变性亚型为野生型ATTR（ATTRwt）（n = 6;平均年龄±SD，81.5±5.6岁）、遗传性ATTR（ATTRv）（n = 3; 68.0±5.7岁）、AL（n = 2; 76.5±0.5岁）和AANF（n = 1; 79岁）（补充表1）。所有ATTR淀粉样变性患者均为VSP阳性（VSP评分！2），而所有AL、AANF和非淀粉样变性患者均为VSP阴性（VSP评分< 2）（图1（A））。VSP阳性（ATTR）组的心肌99 mTc-PYP摄取定量SPECT/CT参数显著高于VSP阴性（非ATTR）组（SUVmax：3.64±0.83 vs. 1.84±0.30，p <0.01）。003; SUV峰值：3.44±0.79 vs. 1.69±0.28，p¼. 004; SUV平均值：2.11±0.44 vs. 1.19±0.29，p¼. 008）。ATTRwt型淀粉样变的SUVmax（4.05±0.62）和SUVpeak（3.84±0.59）明显高于ATTRv型淀粉样变（SUVmax：2.82±0.54，p <0.01）。048，SUV峰值：2.66±0.52，p1/4。048）。在VSP阳性组中，SUV范围倾向于比H/CL范围更宽（图1（A）），表明SUV可以更清楚地区分VSP阳性患者中的淀粉样蛋白负荷。关于淀粉样蛋白成像示踪剂摄取与组织病理学心脏淀粉样蛋白沉积之间的相关性，SUV与病理性淀粉样蛋白沉积等级不显著相关（图1（B））。然而，ATTR淀粉样变性的SUV高于AL淀粉样变性，
The role of bone scintigraphy in the diagnosis of cardiac amyloidosis is becoming increasingly important. On radionuclide imaging, semiquantitative evaluation using planar images, ie visual scoring system (VSp) and heart-to-contralateral (H/CL) ratio, have been used for analyses of cardiac amyloid accumulation. Although those semi-quantitative methods are useful for diagnosing cardiac amyloidosis, they are unsuitable for evaluating disease progression and treatment effect as they cannot detect small changes. This study examined the absolute quantitative evaluation of 99mTc-pyrophosphate (PYP) scintigraphy using a freely available, vendor-neutral software program (GI-BONE; AZE, Tokyo, Japan), in endomyocardial biopsy-proven amyloidosis patients.99mTc-PYP single-photon emission computed tomography/computed tomography (SPECT/CT) images were analysed in 12 consecutive endomyocardial biopsy-proven amyloidosis patients and 1 non-amyloidosis patient. Myocardial 99mTc-PYP accumulation was quantified and standardised uptake value (SUV) max, SUVpeak, and SUVmean were calculated with GI-BONE for comparisons with VSp and H/CL ratio results. The correlation between cardiac tracer uptake and histopathological amyloid infiltration in biopsied myocardial specimens was investigated as well. The amyloidosis subtypes of the patients were wild-type ATTR (ATTRwt)(n¼6; mean age±SD, 81.5±5.6 years), hereditary ATTR (ATTRv)(n¼3; 68.0±5.7 years), AL (n¼2; 76.5±0.5 years), and AANF (n¼1; 79years old)(Supplemental Table 1). All ATTR amyloidosis patients were VSp-positive (VSp score! 2), while all AL, AANF, and non-amyloidosis patients were VSp-negative (VSp score< 2)(Figure 1 (A)). The quantitative SPECT/CT parameters of cardiac 99mTc-PYP uptake in the VSp-positive (ATTR) group were significantly higher than those in the VSp-negative (non-ATTR) group (SUVmax: 3.64±0.83 vs. 1.84±0.30, p¼. 003; SUVpeak: 3.44±0.79 vs. 1.69±0.28, p¼. 004; SUVmean: 2.11±0.44 vs. 1.19±0.29, p¼. 008). SUVmax (4.05±0.62) and SUVpeak (3.84±0.59) in ATTRwt amyloidosis were significantly higher than those in ATTRv amyloidosis (SUVmax: 2.82±0.54, p¼. 048, SUVpeak: 2.66±0.52, p¼. 048). SUV range tended to be broader than H/CL range in the VSp-positive group (Figure 1 (A)), suggesting that SUVs could distinguish amyloid burden more clearly in VSp-positive patients. Regarding the correlation between amyloid imaging tracer uptake and histopathological cardiac amyloid deposition, SUVs were not significantly correlated with pathological amyloid deposition grade (Figure 1 (B)). However, the SUVs for ATTR amyloidosis were higher than those for AL amyloidosis for each
影响因子：
3.9
作者：
Wollenweber T;Rettl R;Kretschmer-Chott E;Rasul S;Kulterer O;Rainer E;Raidl M;Schaffarich MP;Matschitsch S;Stadler M;Traub-Weidinger T;Beiztke D;Loewe C;Duca F;Mascherbauer J;Bonderman D;Hacker M
通讯作者：
Hacker M
影响因子：
2.4
作者：
Bellevre, Dimitri;Bailliez, Alban;Manrique, Alain
通讯作者：
Manrique, Alain
影响因子：
2.4
作者：
Caobelli, Federico;Braun, Martin;Zellweger, Michael J.
通讯作者：
Zellweger, Michael J.