Pitfalls of the Semi-Quantitative Analyzing (99m)Tc-Pyrophosphate Planar Images for Diagnosing Transthyretin Cardiac Amyloidosis: A Possible Solution.
Pitfalls of the Semi-Quantitative Analyzing (99m)Tc-Pyrophosphate Planar Images for Diagnosing Transthyretin Cardiac Amyloidosis: A Possible Solution.
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半定量分析 99mTc-焦磷酸盐平面图像诊断转甲状腺素蛋白心脏淀粉样变性的缺陷：一个可能的解决方案
DOI：
10.3390/diagnostics12010094
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发表时间：
2022-01-01
期刊：
影响因子：
--
通讯作者：
Zhu X
中科院分区：
文献类型：
--
作者：
Zhu Y;Pan R;Peng D;Dong Q;Zhu X
背景：已建立了两种不同的方法，即1小时心对侧(H/CL)比率和3小时肋骨视觉分级(VGsr)，以解释99mTC-PYP平面图像对淀粉样蛋白转甲状腺蛋白心脏淀粉样变性(ATTR-CA)的检测。由于胸骨上段(VGSS)入路易出现缺陷，本研究旨在探讨3h胸骨上段视觉分级法(VGSS)在解释99mTC-PYP平面图像中的诊断实用性。方法：本研究共纳入42例患者。分别采用SPECT/CT法和H/CL比值、VGSR、VGSS等平面法对1 h和3 h的99mTC-PYP图像进行解释，并以最新专家共识建议的分类标准作为金标准。调查了每种方法的解释与黄金标准之间的一致性。结果：除1hSPECT和3hSPECT/CT方法外，3hVGSS方法也适用于平面图像的解释，与金标准一致(κ=1.000；p<；0.001)。结论：对于99mTC-PYP平面图像的解释，3h VGSS方法应是最佳的方法，尤其是在没有可用的或可行的断层成像的情况下。只需在3h进行一次成像(平面和SPECT/CT)即可检测出ATTR-CA，并有利于患者满意度。
Background: Two different approaches, 1-h heart-to-contralateral (H/CL) ratio and 3-h visual grading scale relative to ribs (VGSr), have been established to interpret 99mTc-PYP planar images for the detection of amyloid transthyretin cardiac amyloidosis (ATTR-CA). Since they are prone to pitfalls, this pilot study aimed to explore the diagnostic practicality of the 3-h visual grading scale relative to the upper segment of sternum (VGSs) approach for interpreting 99mTc-PYP planar images. Methods: A total of 42 patients were enrolled in this retrospective study. SPECT/CT approach and planar approaches including H/CL ratio, VGSr, and VGSs were utilized to interpret the 99mTc-PYP images obtained at both 1 and 3 h. The classification criteria of the latest expert consensus recommendations were considered as the gold standard. The concordance between the interpretation of each approach and the gold standard was investigated. Results: In addition to 1- and 3-h SPECT/CT approaches, the interpretation of planar images using the 3-h VGSs approach was also applicable, which turns identical to the gold standard (κ = 1.000; p < 0.001). Conclusions: For the interpretation of 99mTc-PYP planar images, the 3-h VGSs approach should be the optimal method, particularly in the case without available or feasible tomography imaging. Only one imaging session (planar and SPECT/CT) at 3 h would be sufficient for the detection of ATTR-CA, and favorable for patient satisfaction.
DOI：
10.1093/ehjcr/ytaa386
发表时间：
2020-12
期刊：
European heart journal. Case reports
影响因子：
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作者：
Hussain M;Sperry BW;Hanna M;Jaber WA
通讯作者：
Jaber WA