Feasibility of the Absolute Quantification and Left Ventricular Segmentation of Cardiac Sympathetic Innervation in Wild-type Transthyretin Amyloidosis Cardiomyopathy with [¹²³I]-MIBG SPECT/CT: the I-NERVE study.

IF 3 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Nuclear Cardiology Pub Date : 2025-02-03 DOI:10.1016/j.nuclcard.2025.102146

Alwin Tubben, Niek H J Prakken, Oleksandra V Ivashchenko, Hendrea S A Tingen, Andor W J M Glaudemans, Walter Noordzij, Hans L A Nienhuis, Peter van der Meer, Riemer H J A Slart

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引用次数: 0

Abstract

Purpose: Cardiac sympathetic neuronal dysfunction is an early marker in wild-type transthyretin amyloidosis cardiomyopathy (ATTRwt-CM). [¹²³I]-MIBG imaging evaluates cardiac sympathetic innervation but lacks volumetric activity quantification in current methods. This study aims to quantify cardiac sympathetic neuronal dysfunction in ATTRwt-CM using [¹²³I]-MIBG SPECT/CT and correlate findings with functional and structural cardiac parameters from echocardiogram and cardiac magnetic resonance imaging (CMR).

Methods: We conducted a single-center, descriptive, cross-sectional study to quantify absolute myocardial sympathetic function in ATTRwt-CM using [¹²³I]-MIBG SPECT/CT. Retrospective reconstruction allowed for absolute tracer-uptake quantification of the left ventricle, overall and segmented, in kBq/mL, SUV and percentage of the injected dose (%ID). Echocardiography, CMR, and bone scintigraphy were performed according to clinical standards. Segmented [¹²³I]-MIBG SPECT/CT values were correlated with global longitudinal strain (GLSS) on echocardiography, native-T1, and extracellular volume (ECV) on CMR using SPECT/CT fused with CMR.

Results: Twenty-nine ATTRwt-CM patients (75.8±6.6 years, 90% male) were prospectively included. All exhibited cardiac sympathetic neuronal dysfunction, with a median late heart-to-mediastinum ratio of 1.69[1.45-1.89] and a washout rate of 22.7% (16.4-27.3%). SUV_mean, SUV_peak, SUV_max and %ID were 1.80 ± 0.78, 3.84 ± 1.41, 4.46 ± 1.68 and 0.46 ± 0.18 respectively, correlating with semi-quantitative [¹²³I]-MIBG measures. No correlations were found with GLSS on echocardiography or native T1 and ECV on CMR.

Conclusion: The current study demonstrates the feasibility of volumetric quantification of [¹²³I]-MIBG SPECT/CT in ATTRwt-CM. SUV_mean, SUV_peak, SUV_max and %ID correlate with semi-quantitative measures but not with key cardiac parameters on echocardiography or CMR. This confirms the sensitivity of [¹²³I]-MIBG SPECT/CT to different aspects of cardiac function or pathology.

Trial registration: EudraCT ref. 2020-003350-72, retrospectively registered 20 March 2023. https://classic.

Clinicaltrials: gov/ct2/show/NCT05776212.

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来源期刊

Journal of Nuclear Cardiology 医学-核医学

CiteScore

5.30

自引率

20.80%

发文量

249

审稿时长

4-8 weeks

期刊介绍： Journal of Nuclear Cardiology is the only journal in the world devoted to this dynamic and growing subspecialty. Physicians and technologists value the Journal not only for its peer-reviewed articles, but also for its timely discussions about the current and future role of nuclear cardiology. Original articles address all aspects of nuclear cardiology, including interpretation, diagnosis, imaging equipment, and use of radiopharmaceuticals. As the official publication of the American Society of Nuclear Cardiology, the Journal also brings readers the latest information emerging from the Society''s task forces and publishes guidelines and position papers as they are adopted.