SPECT/CT SUV-based metrics: A promising diagnostic tool in classifying patients with suspected transthyretin cardiac amyloidosis among the different Perugini grades?

IF 0.9 4区医学 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Hellenic journal of nuclear medicine Pub Date : 2023-09-01 Epub Date: 2023-12-14 DOI:10.1967/s002449912601

Sophia Koukouraki, Nikolaos Kapsoritakis, Olga Bourogianni, Maria Stathaki, Ioannis Zaganas, Alexandros Patrianakos, Anthi Plevritaki, Dafni Korela, Maria Marketou, Emmanouil Foukarakis

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引用次数: 0

Abstract

Objective: The purpose of this study was to evaluate the contribution of single photon emission computed tomography/computed tomography (SPECT/CT) standardized uptake value (SUV) metrics in classifying patients with suspected transthyretin cardiac amyloidosis (ATTR-CA) among the different Perugini grades.

Subjects and methods: One hundred four patients suspected of ATTR-CA underwent planar scintigraphy with bone seeking tracer (^99mTc pyrophosphate-PYP). Patients were classified according to the Perugini scale, the H/CL, H/Bone and H/Bkg ratios. A subset of 48 patients received additional SPECT/CT. Single photon emission computed tomography/CT SUV quantitative parameters, of the heart, myocardium, lungs, liver, soft tissues, bone, and SUV ratios (SUV_maxmyo, SUV_maxlungs, SUV_maxliver, SUV_maxbone and SUV_maxsoft tissue ratios), were evaluated in order to investigate potential metrics that could more clearly differentiate Perugini grades.

Results: A total of 33.7% of patients were considered grade 0, 34.6% grade 1 and 31.7% grade 2/3. A combination of H/CL >1.33 and H/Bone >0.85 showed the highest sensitivity 100%. Standardized uptake value-based metrics clearly differentiated grade 0 or 1 vs grades 2 or 3, whereas no significant difference was found between grades 0 and 1, or between grades 1 and 2. The combined cut-off values H/CL 1.33 and SUV_maxmyo 2.88 yielded 100% sensitivity and 84.6% specificity in differentiating ATTR-CA positives vs negatives. The metric SUV_maxmyo/SUV_maxliver was the best metric to classify patients with grade 1 as negative (grade 0) or positive (grade 2 or 3).

Conclusion: Single photon emission computed tomography/CT SUV metrics could be complementary to planar scintigraphy in classifying patients among the different Perugini grades. The ratio SUV_maxmyo/SUV_maxliver was the only parameter with high affinity to differentiate patients with grade 1, as grade 0 or grade 2/3 for ATTR-CA.

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基于SPECT/CT SUV的指标：将疑似转甲状腺素心脏淀粉样变性患者划分为不同佩鲁吉尼分级的有前途的诊断工具？

研究目的本研究旨在评估单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）标准化摄取值（SUV）指标在将疑似转甲状腺素心脏淀粉样变性（ATTR-CA）患者划分为不同的佩鲁吉尼分级中的贡献：144 名疑似 ATTR-CA 患者接受了寻骨示踪剂（99m锝焦磷酸-PYP）平面扫描。根据佩鲁吉尼量表、H/CL、H/骨和 H/Bkg 比率对患者进行分类。48名患者中的一部分接受了额外的SPECT/CT检查。对心脏、心肌、肺、肝、软组织、骨的单光子发射计算机断层扫描/CT SUV 定量参数和 SUV 比值（SUVmaxmyo、SUVmaxlungs、SUVmaxliver、SUVmaxbone 和 SUVmaxsoft tissue ratio）进行了评估，以研究能更明确区分佩鲁吉尼分级的潜在指标：共有 33.7% 的患者被认定为 0 级，34.6% 为 1 级，31.7% 为 2/3 级。H/CL>1.33和H/Bone>0.85的组合显示出最高的灵敏度（100%）。基于摄取值的标准化指标可明确区分 0 级或 1 级与 2 级或 3 级，而 0 级与 1 级之间或 1 级与 2 级之间则无明显差异。在区分 ATTR-CA 阳性与阴性时，H/CL 1.33 和 SUVmaxmyo 2.88 的组合临界值可产生 100% 的灵敏度和 84.6% 的特异性。SUVmaxmyo/SUVmaxliver指标是将1级患者分为阴性（0级）或阳性（2级或3级）的最佳指标：结论：单光子发射计算机断层扫描/CT SUV指标可作为平面闪烁扫描的补充，用于将患者划分为不同的佩鲁吉尼分级。SUVmaxmyo/SUVmaxliver的比值是唯一能将ATTR-CA分级为1级、0级或2/3级的高亲和力参数。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hellenic journal of nuclear medicine 医学-核医学

CiteScore

1.40

自引率

6.70%

发文量

审稿时长

>12 weeks

期刊介绍： The Hellenic Journal of Nuclear Medicine published by the Hellenic Society of Nuclear Medicine in Thessaloniki, aims to contribute to research, to education and cover the scientific and professional interests of physicians, in the field of nuclear medicine and in medicine in general. The journal may publish papers of nuclear medicine and also papers that refer to related subjects as dosimetry, computer science, targeting of gene expression, radioimmunoassay, radiation protection, biology, cell trafficking, related historical brief reviews and other related subjects. Original papers are preferred. The journal may after special agreement publish supplements covering important subjects, dully reviewed and subscripted separately.