Semi-quantitative evaluation of early phase 99mTc-DPD scintigraphy in patients with suspected cardiac amyloidosis

IF 2.4 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Annals of Nuclear Medicine Pub Date : 2026-04-16 DOI:10.1007/s12149-026-02209-w

Lukas Kessler, Leon Ferber, Christoph Rischpler, Stephan Settelmeier, Tugce Telli, Zohreh Varasteh, Clemens P. Spielvogel, Tim Hagenacker, Wolfgang P. Fendler, Alexander Carpinteiro, Lars Michel, Ken Herrmann, Tienush Rassaf, Miriam Sraieb, David Kersting

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引用次数: 0

Abstract

Background

Scintigraphy using bone-avid tracers like ^99mTc-diphosphono-propanodicarboxylic acid (^99mTc-DPD), ^99mTc-hydroxymethylene-diphosphonate (^99mTc-HMDP), or ^99mTc-pyrophosphate (^99mTc-PYP) is a widely available and non-invasive imaging tool for diagnosis of cardiac amyloidosis. Visual evaluation and semi-quantitative image analyses reach excellent sensitivity and specificity results. For ^99mTc-HMDP, high accuracy of early semi-quantitative parameters derived from imaging 10 min after tracer injection was described but never validated for other tracers. The aim of this study was to evaluate early semi-quantitative parameters in ^99mTc-DPD scintigraphy.

Methods

122 patients (78 male / 44 female) with suspected cardiac amyloidosis who underwent ^99mTc-DPD scintigraphy were retrospectively analysed. Early and late planar whole-body scintigraphy images were acquired 10 min (+ 5 min) and 2.5–3.5 h after tracer injection. Early cardiac ^99mTc-DPD uptake was evaluated using the Heart/whole-body rectangular (H/WBr), Heart/whole-body profile (H/WBp), Heart/Skull (H/S), Heart/Mediastinum (H/M), Heart/Contralateral Lung (H/CL), Heart/Liver (H/L), and Heart/Pelvis (H/P) ratios.

Results

H/L was not correlated to the other parameters.Best results for prediction of Perugini ≥1 were achieved for H/M (sensitivity 69.6%, specificity 84.4%, accuracy 77.5%), best results for prediction of ATTR-CA for H/L (sensitivity 65.9%, specificity 88.6%, accuracy 80.8%). Adding the H/L to other parameters increased accuracy and specificity (best results for H/L+H/S: accuracy 83.3%, sensitivity 63.4%, specificity 93.7% to predict CA).

Conclusion

Previous results for^99mTc-HMDP were not confirmed; diagnostic precision of early ^99mTc-DPD is not sufficient to replace late imaging in clinical routine. Early H/L is a novel, independent, and specific parameter which may be added to imaging protocols to increase the accuracy in combination with other imaging biomarkers

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疑似心脏淀粉样变性患者早期99mTc-DPD闪烁成像的半定量评价。

背景：使用骨示踪剂如99mtc -二膦-丙二甲酸（99mTc-DPD）、99mtc -羟亚甲基-二膦酸盐（99mTc-HMDP）或99mtc -焦磷酸盐（99mTc-PYP）的闪烁成像是一种广泛使用的无创心脏淀粉样变性诊断成像工具。目视评价和半定量图像分析获得了良好的灵敏度和特异性结果。对于99mTc-HMDP，描述了在注射示踪剂后10分钟成像获得的早期半定量参数的高精度，但尚未验证其他示踪剂。本研究的目的是评估99mTc-DPD闪烁成像的早期半定量参数。方法：回顾性分析122例（男78例，女44例）行99mTc-DPD显像检查的疑似心脏淀粉样变性患者。示踪剂注射后10 min （+ 5 min）和2.5 ~ 3.5 h分别获得早期和晚期平面全身闪烁成像。采用心脏/全身矩形（H/WBr）、心脏/全身轮廓（H/WBp）、心脏/颅骨（H/S）、心脏/纵隔（H/M）、心脏/对侧肺（H/CL）、心脏/肝脏（H/L）和心脏/骨盆（H/P）比值评估早期心脏99mTc-DPD摄取。结果：H/L与其他参数无相关性。预测H/M Perugini≥1的最佳结果为敏感性69.6%，特异性84.4%，准确性77.5%；预测atr - ca H/L的最佳结果为敏感性65.9%，特异性88.6%，准确性80.8%。在其他参数中加入H/L可提高预测CA的准确性和特异性（H/L+H/S预测CA的最佳结果为准确性83.3%，敏感性63.4%，特异性93.7%）。结论：99mtc - hmdp的既往结果未得到证实；早期99mTc-DPD的诊断精度不足以取代临床常规的晚期影像学检查。早期H/L是一种新的、独立的、特定的参数，可以添加到成像方案中，以提高与其他成像生物标志物结合的准确性

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

Annals of Nuclear Medicine 医学-核医学

CiteScore

4.90

自引率

7.70%

发文量

111

审稿时长

4-8 weeks

期刊介绍： Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine. The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.