Circulation: Cardiovascular Imaging最新文献

{"title":"Pathology-Based Validation of Quantitative SPECT/CT in Patients With Suspected Transthyretin Amyloid Cardiomyopathy.","authors":"Gregorio Tersalvi, Melanie C Bois, Christopher G Scott, Patricia Carey, Armin Garmany, Daniel R Davies, Andrew C Hoffman, Jun Zhang, Carrie B Hruska, Hayan Jouni, Martin G Rodriguez-Porcel, J Wells Askew, John P Bois, Kathleen A Young, Nandan S Anavekar, Ian C Chang, Martha Grogan, Angela Dispenzieri, Joseph J Maleszewski, Andrew C Homb, Margaret M Redfield, Panithaya Chareonthaitawee, Geoffrey B Johnson, Omar F AbouEzzeddine","doi":"10.1161/CIRCIMAGING.126.019832","DOIUrl":"10.1161/CIRCIMAGING.126.019832","url":null,"abstract":"<p><strong>Background: </strong>Technetium-based cardiac amyloid radionuclide imaging enables noninvasive diagnosis of transthyretin amyloid cardiomyopathy (ATTR-CM), but conventional planar and visual semiquantitative approaches have important limitations. We developed the quantitative 3-dimensional Mayo 3D Score, defined as the ratio of mean left ventricular myocardial radiotracer uptake to right atrial blood-pool uptake using computed tomography (CT)-fused single-photon emission CT (SPECT) volumes of interest, and sought to validate its diagnostic performance against myocardial pathology.</p><p><strong>Methods: </strong>Consecutive patients who underwent ^99mTc-pyrophosphate SPECT/CT at Mayo Clinic for suspected ATTR-CM between June 2017 and January 2025 with archived myocardial tissue were included. Baseline characteristics, including demographics, echocardiogram, biomarkers, visual semiquantitative, and Mayo 3D Score metrics, were collected. Myocardial specimens underwent histopathologic confirmation of amyloid, with amyloid subtype determination and further semiquantitative grading of amyloid burden and deposition patterns.</p><p><strong>Results: </strong>Among 230 patients (median age, 72 years; 78% male), 107 (47%) had ATTR-CM, of whom 9 had hereditary ATTR-CM. The Mayo 3D Score showed excellent discrimination against pathology (area under the receiver operating characteristic curve, 0.92 [0.88-0.96]), exceeding planar Perugini (0.87 [0.83-0.92]; <i>P</i>=0.006), and heart-to-contralateral lung ratio (0.86 [0.81-0.91]; <i>P</i>=0.004) and comparable to SPECT Perugini (0.90 [0.86-0.94]; <i>P</i>=0.12). A cutoff ≥1.0 yielded 86.0% sensitivity, 92.7% specificity, 91.1% positive predictive value, and 88.4% negative predictive value. Among ATTR-positive cases, the Mayo 3D Score correlated strongly with semiquantitative amyloid burden (Spearman ρ=0.69), was higher in pericellular than nodular deposition patterns (<i>P</i><0.001), and was not associated with vascular involvement (<i>P</i>=0.42).</p><p><strong>Conclusions: </strong>In patients with suspected ATTR-CM undergoing ^99mTc-pyrophosphate SPECT/CT, the Mayo 3D Score demonstrated superior diagnostic performance compared with planar metrics and comparable to SPECT Perugini, while correlating with myocardial ATTR burden and deposition patterns on pathology. These findings support its integration as a quantitative adjunct within clinical diagnostic ATTR-CM workflows.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019832"},"PeriodicalIF":9.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148560905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathology-Based Validation of the Mayo 3D Score: An Important Step Toward Quantitative ATTR-CM Imaging.","authors":"Elise Fraser, Wael A Jaber","doi":"10.1161/CIRCIMAGING.126.020212","DOIUrl":"10.1161/CIRCIMAGING.126.020212","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e020212"},"PeriodicalIF":9.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148560914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative CZT SPECT Myocardial Blood Flow for Physiological Assessment and Risk Stratification of Cardiac Allograft Vasculopathy.","authors":"Paul Hart, Anas Jawaid, Jeffrey Fitch, Natalia Aerton, Erin M Armenia, Maria L Mackin, Sneha Limaye, Steven Avino, Paul Blasio, Dillon J Dzikowicz, Paco E Bravo, Leway Chen, Ronald G Schwartz","doi":"10.1161/CIRCIMAGING.126.019747","DOIUrl":"10.1161/CIRCIMAGING.126.019747","url":null,"abstract":"<p><strong>Background: </strong>Cardiac allograft vasculopathy (CAV) remains a major cause of morbidity and mortality after orthotopic heart transplantation. Although positron emission tomography myocardial perfusion imaging with quantitative myocardial blood flow (MBF) effectively detects CAV, access remains limited. Cadmium-zinc-telluride (CZT) single-photon emission computed tomography (SPECT) enables quantitative MBF assessment and may provide a more accessible alternative. However, the diagnostic and prognostic value of quantitative CZT SPECT-derived MBF for CAV is unknown.</p><p><strong>Methods: </strong>We retrospectively studied 110 consecutive orthotopic heart transplantation recipients who underwent coronary angiography and CZT SPECT quantitative MBF imaging within 12 months. Stress MBF, rest MBF, MBF reserve, coronary flow capacity, and total perfusion deficit were compared across International Society for Heart and Lung Transplantation CAV categories. The diagnostic performance of the established (Bravo) and modified (Hart) flow-based algorithms was evaluated by receiver operating characteristic analysis. Associations with CAV-related events were assessed.</p><p><strong>Results: </strong>Over 2.3±1.0 years, stress MBF declined progressively with increasing CAV severity (<i>P</i>=0.007) and was lower in patients with CAV 2 to 3 than in those with CAV 0 to 1 (1.25±0.52 versus 2.03±0.81 mL/min per g; <i>P</i>=0.003). The Bravo and Hart algorithms showed similar discrimination of advanced CAV by paired DeLong comparison (area under the curve, 0.773 versus 0.717; Δ area under the curve, 0.056; <i>P</i>=0.606). Severely reduced coronary flow capacity was associated with higher event rates (28.6% versus 5.2%; <i>P</i>=0.015). The Hart framework demonstrated exploratory prognostic separation (35.3% versus 3.2%; <i>P</i>=0.001).</p><p><strong>Conclusions: </strong>Quantitative CZT SPECT-derived MBF and coronary flow capacity provide physiological assessment and risk stratification of CAV, with preliminary associations with CAV-related events. These findings support the prospective multicenter evaluation of CZT SPECT MBF as a widely available, noninvasive orthotopic heart transplantation surveillance strategy.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019747"},"PeriodicalIF":9.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148560969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal [¹⁸F]FDG PET/MR Assessment of Arterial Inflammation in Patients With Prostate Cancer Undergoing Androgen Deprivation Therapy.","authors":"Song Xue, Chenming Hu, Lianghua Li, Holger Einspieler, Attila Kiss, Bruno K Podesser, Jutta Bergler-Klein, Marcus Hacker, Xiang Li, Xiang Zhou, Jianjun Liu","doi":"10.1161/CIRCIMAGING.126.019636","DOIUrl":"10.1161/CIRCIMAGING.126.019636","url":null,"abstract":"<p><strong>Background: </strong>Androgen deprivation therapy (ADT) improves outcomes in advanced prostate cancer but is associated with increased cardiovascular morbidity and mortality. Arterial inflammation, measurable by [¹⁸F]fluorodeoxyglucose positron emission tomography, may represent an intermediate pathway linking ADT to cardiovascular risk. We quantified intraindividual changes in arterial inflammation on [¹⁸F]fluorodeoxyglucose positron emission tomography/magnetic resonance across ADT exposure, characterized their temporal trajectory, and explored associated clinical factors.</p><p><strong>Methods: </strong>Forty-three men with prostate cancer underwent 2 longitudinal [¹⁸F]fluorodeoxyglucose positron emission tomography/magnetic resonance examinations across the course of ADT exposure. The maximum standardized uptake value was measured in the common carotid arteries, aortic arch, ascending and descending thoracic aorta, abdominal aorta, and common iliac arteries. Arterial inflammation was expressed as the maximum target-to-background ratio (TBR_max) by normalizing arterial (maximum standardized uptake value) to the venous blood-pool mean standardized uptake value. Segmental values were aggregated into all-artery, aorta, and branch composite measures. Paired changes were assessed using paired tests, and longitudinal trajectories were modeled using linear mixed-effects models.</p><p><strong>Results: </strong>ADT was associated with significant intraindividual increases in TBR_max in the carotid arteries (1.54±0.32 to 1.75±0.31; <i>P</i><0.001), abdominal aorta (1.89±0.39 to 2.19±0.36; <i>P</i><0.001), common iliac arteries (1.88±0.45 to 2.24±0.54; <i>P</i><0.001), aortic arch (<i>P</i>=0.005), and ascending aorta (<i>P</i>=0.02). All-artery, aorta, and branch composite TBR_max increased significantly (all <i>P</i><0.001). Longitudinal models showed progressive, time-dependent rises in TBR_max, with the largest monthly increments in iliac arteries (0.0205/mo; <i>P</i><0.001), carotid arteries (0.0123/mo; <i>P</i><0.001), and abdominal aorta (0.0098/mo; <i>P</i>=0.038).</p><p><strong>Conclusions: </strong>In patients with prostate cancer, ADT is associated with consistent and progressive arterial inflammation, most prominently in carotid, iliac, and abdominal aortic regions. These findings support arterial inflammation as a potential imaging phenotype of ADT-associated cardiovascular risk.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019636"},"PeriodicalIF":9.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RACI: A Novel Prognostic Marker in Functional Tricuspid Regurgitation.","authors":"Robert S Zhang, Giorgia Falco, Emily Li, Pablo Villar-Calle, Mahniz Reza, Edmund Naami, Elizabeth Manowitz, Prianca Tawde, Radhika Narasimhan, Mojdeh Yadollahikhales, Lisa Q Rong, Arindam RoyChoudhury, Jonathan W Weinsaft, Jiwon Kim","doi":"10.1161/CIRCIMAGING.126.019813","DOIUrl":"10.1161/CIRCIMAGING.126.019813","url":null,"abstract":"<p><strong>Background: </strong>Right atrioventricular coupling index (RACI), defined as the ratio of right atrial (RA) to right ventricular (RV) end-diastolic volume on cardiac magnetic resonance, is a novel parameter that reflects RA-RV hemodynamic interplay. Its prognostic value in functional tricuspid regurgitation (TR) is unknown.</p><p><strong>Methods: </strong>This study included 633 consecutive patients with moderate or greater functional TR undergoing cardiac magnetic resonance. Patients were stratified into 2 groups based on the optimal cutoff by the Youden index (normal: RACI<0.62 versus high: RACI≥0.62). The primary outcome was all-cause mortality.</p><p><strong>Results: </strong>Patients with high RACI (n=147) were older (74.1±10.7 years versus 60.6±16.1 years, <i>P</i><0.001) with larger RA volumes (RA end-systolic volume index: 96.7 [interquartile range, 77.5-121.2] mL/m² versus 55.4 [interquartile range, 42.6-69.0] mL/m²; <i>P</i><0.001), smaller RV size (RV end-diastolic volume index: 106.2±33.5 versus 114.8±37.2 mL/m²; <i>P</i>=0.012), and no difference in RV function (RV ejection fraction: 46.3±9.8% versus 45.4±12.7%; <i>P</i>=0.43). Over a median follow-up of 2.9 years (interquartile range, 0.7-6.9), a high RACI was associated with increased mortality risk (25% versus 15%; hazard ratio, 2.06 [95% CI, 1.47-2.90]; <i>P</i><0.001). In multivariable Cox regression analysis adjusting for age, right and left heart size and function, and clinical markers of right-sided congestion (glomerular filtration rate <30, total bilirubin), RACI remained an independent predictor of all-cause mortality (adjusted hazard ratio, 1.16 per 0.10 increase, 95% CI, 1.03-1.32, <i>P</i>=0.014). In addition, RACI provided incremental prognostic value for predicting the primary outcome over conventional right heart indices (RA and RV volumes, RV ejection fraction, TR severity), improving model performance (χ² increased from 28.5 to 37.6; <i>P</i>=0.003).</p><p><strong>Conclusions: </strong>RACI is a novel parameter that effectively integrates RA and RV remodeling, and independently predicts all-cause mortality in functional TR. Incorporating RACI into clinical assessment may help with improving risk stratification and guiding the timing of intervention in patients with functional TR.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019813"},"PeriodicalIF":9.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Lumen: Physiological Surveillance of the Cardiac Allograft.","authors":"Alessia Gimelli, Brett W Sperry","doi":"10.1161/CIRCIMAGING.126.020219","DOIUrl":"10.1161/CIRCIMAGING.126.020219","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e020219"},"PeriodicalIF":9.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardized Acquisition of Fetal Cardiac Cine MRI: A Practical Guide.","authors":"Gloria Biechele, Frederique de Vries, Bertrand Stos, Daniela Laux, Neil Derridj, Rabea Klaar, Bernd Wintersperger, Sophia Stoecklein, David Grevent, Laurent J Salomon","doi":"10.1161/CIRCIMAGING.126.019755","DOIUrl":"10.1161/CIRCIMAGING.126.019755","url":null,"abstract":"<p><p>Fetal ultrasound is the primary screening modality for routine prenatal examinations, but its effectiveness can be influenced by factors such as maternal body habitus, polyhydramnios, or fetal position. Although magnetic resonance imaging (MRI) is well established for fetal brain and body imaging, cardiac assessment has been restricted by the absence of reliable cardiac gating and motion compensation strategies. Only recently have advances in fetal cardiac rhythm monitoring within the MRI scanner enabled retrospective gating, paving the way for clinical use of fetal cardiac MRI. However, a reproducible and standardized imaging protocol for systematic cardiac assessment on cine sequences has not yet been universally adopted. This article proposes a practical framework for fetal cardiac cine MRI acquisition and interpretation based on a segmental approach consistent with standard fetal echocardiographic orientations, while also incorporating ungated T2-weighted imaging with slice-to-volume reconstruction for the assessment of extracardiac vascular anatomy. Representative cases with annotated anatomic landmarks illustrate how MRI can be integrated into a multimodality prenatal imaging strategy. The development of a standardized protocol may facilitate reproducibility across centers and support the incorporation of fetal cardiac MRI as a complementary tool within comprehensive prenatal cardiac evaluation.</p>","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019755"},"PeriodicalIF":9.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomic Labyrinth: Hepatic Malrotation and Prehepatic IVC Course Precluding Femoral Access for ASD Closure.","authors":"Wei-Lin Yang, Bi-Yue Hu","doi":"10.1161/CIRCIMAGING.126.019936","DOIUrl":"10.1161/CIRCIMAGING.126.019936","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019936"},"PeriodicalIF":9.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter by Dyar and Oxborough Regarding Article, \"Assessing Left Atrial Volume Indexation to Predict Mortality in Individuals With Overweight or Obesity\".","authors":"Dan A Dyar, David L Oxborough","doi":"10.1161/CIRCIMAGING.126.020095","DOIUrl":"https://doi.org/10.1161/CIRCIMAGING.126.020095","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e020095"},"PeriodicalIF":9.1,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant Hemorrhagic Pericardial Cyst Mimicking Primary Cardiac Lymphoma by Coronary Artery Encasement.","authors":"Kenta Uno, Suguru Araki, Shiro Nakamori, Satoshi Nakamura, Tetsuji Kitano, Taku Omori, Miyuko Fujita, Akihide Nakamura, Masaki Ishida, Kakuya Kitagawa, Yu Shomura, Kazuaki Maruyama, Naoto Kumagai, Hajime Sakuma, Kaoru Dohi","doi":"10.1161/CIRCIMAGING.126.019784","DOIUrl":"10.1161/CIRCIMAGING.126.019784","url":null,"abstract":"","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e019784"},"PeriodicalIF":9.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}