Damien Legallois, Lucas Turcan, Denis Agostini, Alain Manrique
{"title":"Test-retest Reproducibility of Myocardial <sup>99m</sup>Tc-HMDP Uptake Quantification by SPECT-CT in Suspected Transthyretin Cardiac Amyloidosis.","authors":"Damien Legallois, Lucas Turcan, Denis Agostini, Alain Manrique","doi":"10.1016/j.nuclcard.2025.102273","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Diagnosing transthyretin-related cardiac amyloidosis (ATTR-CA) relies on excluding plasma cell dyscrasia and performing bone-avid tracer cardiac scintigraphy. However, visual assessment of cardiac uptake has limitations in evaluating amyloid burden. Whole-body SPECT-CT may overcome these limitations by enabling quantitative assessment, but data on test-retest reproducibility is lacking.</p><p><strong>Objectives: </strong>This study aimed to evaluate the test-retest, intra- and interobserver reproducibility of cardiac amyloid quantification in suspected ATTR-CA using whole-body cadmium zinc telluride SPECT-CT.</p><p><strong>Methods: </strong>Twenty patients with suspected ATTR-CA underwent repeated planar bone-avid tracer cardiac scintigraphy and thoracic SPECT-CT one week apart (October 2020-December 2022; Clinical Trial: NCT04535349). The Perugini score was assessed using planar acquisition. Cardiac 99mTc-HMDP uptake was quantified on SPECT images with CT-based cardiac contouring and attenuation correction. The evaluated metrics included maximum standardized uptake values (SUVmax), SUVmean, percentage of injected dose (%ID), and cardiac amyloid activity (CAA). Concordance was evaluated by Lin's concordance correlation coefficient (CCC). Test-retest reproducibility was assessed using the mean absolute difference, coefficient of variation, and intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>Intra- and interobserver reproducibility was excellent for all metrics (CCC ≥ 0.99). Test-retest reproducibility demonstrated substantial agreement for SUVmean (CCC: 0.79) and almost perfect agreement for SUVmax (CCC: 0.81), %ID (CCC: 0.88), and CAA (CCC: 0.93). All parameters correlated with the Perugini score. Test-retest reliability was high across metrics, with ICC values of 0.80-0.97.</p><p><strong>Conclusions: </strong>Bone-avid tracer cardiac SPECT-CT shows excellent reproducibility for quantifying cardiac amyloid burden in suspected ATTR-CA, with %ID and CAA being especially reliable for future longitudinal studies.</p><p><strong>Clinical trial registration: </strong>NCT04535349.</p>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":" ","pages":"102273"},"PeriodicalIF":3.0000,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Nuclear Cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.nuclcard.2025.102273","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Diagnosing transthyretin-related cardiac amyloidosis (ATTR-CA) relies on excluding plasma cell dyscrasia and performing bone-avid tracer cardiac scintigraphy. However, visual assessment of cardiac uptake has limitations in evaluating amyloid burden. Whole-body SPECT-CT may overcome these limitations by enabling quantitative assessment, but data on test-retest reproducibility is lacking.
Objectives: This study aimed to evaluate the test-retest, intra- and interobserver reproducibility of cardiac amyloid quantification in suspected ATTR-CA using whole-body cadmium zinc telluride SPECT-CT.
Methods: Twenty patients with suspected ATTR-CA underwent repeated planar bone-avid tracer cardiac scintigraphy and thoracic SPECT-CT one week apart (October 2020-December 2022; Clinical Trial: NCT04535349). The Perugini score was assessed using planar acquisition. Cardiac 99mTc-HMDP uptake was quantified on SPECT images with CT-based cardiac contouring and attenuation correction. The evaluated metrics included maximum standardized uptake values (SUVmax), SUVmean, percentage of injected dose (%ID), and cardiac amyloid activity (CAA). Concordance was evaluated by Lin's concordance correlation coefficient (CCC). Test-retest reproducibility was assessed using the mean absolute difference, coefficient of variation, and intraclass correlation coefficient (ICC).
Results: Intra- and interobserver reproducibility was excellent for all metrics (CCC ≥ 0.99). Test-retest reproducibility demonstrated substantial agreement for SUVmean (CCC: 0.79) and almost perfect agreement for SUVmax (CCC: 0.81), %ID (CCC: 0.88), and CAA (CCC: 0.93). All parameters correlated with the Perugini score. Test-retest reliability was high across metrics, with ICC values of 0.80-0.97.
Conclusions: Bone-avid tracer cardiac SPECT-CT shows excellent reproducibility for quantifying cardiac amyloid burden in suspected ATTR-CA, with %ID and CAA being especially reliable for future longitudinal studies.
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.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
