A Routine PET/CT Protocol with Streamlined Calculations for Assessing Cardiac Amyloidosis Using (18)F-Florbetapir.
A Routine PET/CT Protocol with Streamlined Calculations for Assessing Cardiac Amyloidosis Using (18)F-Florbetapir.
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DOI：
10.3389/fcvm.2015.00023
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发表时间：
2015
影响因子：
3.6
通讯作者：
Wall JS
中科院分区：
文献类型：
--
作者：
Osborne DR;Acuff SN;Stuckey A;Wall JS
心脏淀粉样变性是一种罕见的疾病，其特征是结构良好的蛋白质纤维、蛋白聚糖和血清蛋白沉积为淀粉样蛋白。最近的工作表明，它可能会使用18F-Florbetapir图像心脏淀粉样变性。目前的评估方法包括侵入性活检技术。这项工作增强了Dorbala等人的基础工作，通过开发使用18F-Florbetapir进行心脏淀粉样蛋白评估的常规成像和分析方案。11名患者，3名健康对照和8名髓样蛋白阳性患者，使用18F-Florbetapir成像，以评估心脏淀粉样蛋白负荷。其中4名患者还使用82 Rb-氯化物进行成像，以评估由于心肌血流量减少而可能导致的18 F-Florbetapir滞留。使用建模、SUV和SUV比率的定量方法来定义新的简化的临床成像方案，该方案可以常规使用并提供患者分层。18F-Florbetapir心脏淀粉样蛋白数据的定量分析是从20分钟列表模式方案中编译的，其中数据在0-5、10-15或15-20分钟时被直方图化成两个静态图像。数据分析表明，使用SUV或从间隔壁区域绘制计算的SUV比率足以在该小队列中从淀粉样蛋白阳性患者中识别所有健康对照。此外，我们发现有可能使用这种方法来区分患有AL与TTR淀粉样蛋白的患者。这项工作建立在Dorbala等人的开创性工作的基础上，通过描述一种适用于常规临床使用的短18F-Florbetapir成像方案，并使用一种简单的方法定量分析心脏淀粉样疾病。
Cardiac amyloidosis is a rare condition characterized by the deposition of well-structured protein fibrils, proteoglycans, and serum proteins as amyloid. Recent work has shown that it may be possible to use 18F-Florbetapir to image cardiac amyloidosis. Current methods for assessment include invasive biopsy techniques. This work enhances foundational work by Dorbala et al. by developing a routine imaging and analysis protocol using 18F-Florbetapir for cardiac amyloid assessment. Eleven patients, three healthy controls and eight myloid positive patients, were imaged using 18F-Florbetapir to assess cardiac amyloid burden. Four of the patients were also imaged using 82Rb-Chloride to evaluate possible 18F-Florbetapir retention because of reduced myocardial blood flow. Quantitative methods using modeling, SUVs and SUV ratios were used to define a new streamlined clinical imaging protocol that could be used routinely and provide patient stratification. Quantitative analysis of 18F-Florbetapir cardiac amyloid data were compiled from a 20-min listmode protocol with data histogrammed into two static images at 0–5, 10–15, or 15–20 min. Data analysis indicated the use of SUVs or ratios of SUVs calculated from regions draw in the septal wall were adequate in identification of all healthy controls from amyloid positive patients in this small cohort. Additionally, we found that it may be possible to use this method to differentiate patients suffering from AL vs. TTR amyloid. This work builds on the seminal work by Dorbala et al. by describing a short 18F-Florbetapir imaging protocol that is suitable for routine clinical use and uses a simple method for quantitative analysis of cardiac amyloid disease.