Journal of Nuclear Cardiology最新文献

{"title":"A Case of Complex Prosthetic Valve Endocarditis: Unexpected Embolic Findings with Clinical Implications.","authors":"Nayme Luisa Calviño, Sonia Romero, M Jesús Diez, Azahara Palomar-Muñoz, Maria Nazarena Pizzi, Alberto Roque Pérez","doi":"10.1016/j.nuclcard.2025.102276","DOIUrl":"https://doi.org/10.1016/j.nuclcard.2025.102276","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":" ","pages":"102276"},"PeriodicalIF":3.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unexpected insight: Rubidium-82 PET/CT myocardial perfusion imaging uncovers malignant pleural mesothelioma.","authors":"William Hs Spiller, Banu SathyaMurthi, Parthiban Arumugam","doi":"10.1016/j.nuclcard.2025.102264","DOIUrl":"https://doi.org/10.1016/j.nuclcard.2025.102264","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":" ","pages":"102264"},"PeriodicalIF":3.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic performance of ¹⁸F-flurpiridaz PET myocardial perfusion imaging with total perfusion deficit quantification.","authors":"Jennifer M Renaud, Jonathan B Moody, Michael D Vanderver, Alexis Poitrasson-Rivière, Christopher J Buckley, Edward P Ficaro, Venkatesh L Murthy","doi":"10.1016/j.nuclcard.2025.102266","DOIUrl":"https://doi.org/10.1016/j.nuclcard.2025.102266","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the diagnostic performance of ¹⁸F-flupiridaz PET myocardial perfusion imaging (MPI) for coronary artery disease detection using total perfusion deficit (TPD), an automated metric of combined disease extent and severity.</p><p><strong>Methods: </strong>Flurpiridaz relative perfusion images and quantitative coronary angiography data from the initial phase III trial were evaluated using receiver operating characteristic analysis at separate endpoints of ≥ 70% stenosis, and ≥ 50% stenosis, to determine the diagnostic performance of TPD at per-patient (global LV) and per-vessel levels. TPD results at both endpoints were compared with the performance of visual scores and defect extent values available from two previous publications.</p><p><strong>Results: </strong>Using a normal perfusion database that was created with the data of 25 patients from the flurpiridaz trial population, TPD was calculated in the remaining 729 trial subjects. At the threshold of ≥ 70% stenosis, TPD was observed to have similar (p ≥ 0.05) per-patient diagnostic performance (74% accuracy) to visual scoring from previous publications (75%, 71%), as well as defect extent (72%). At the per-vessel level, TPD achieved similar performance to defect extent in the LAD and LCx (79%, 74% vs. 80%, 72% accuracy) with slightly higher accuracy in the RCA (77% vs 72%, p = 0.03), and similar performance to visual scoring in the LAD and RCA (77, 79% vs. 76%, 76% accuracy) with marginally lower performance in the LCx (74% vs 79%, p = 0.03. Similar results were observed at the ≥ 50% obstructive disease endpoint.</p><p><strong>Conclusions: </strong>Automated TPD demonstrated similar diagnostic performance for global and regional flurpiridaz PET MPI, respectively, to visual scoring and defect extent quantification.</p>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":" ","pages":"102266"},"PeriodicalIF":3.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of PET-CT and CZT-SPECT on Myocardial Blood Flow and Flow Reserve measurement: a systematic review and meta-analysis.","authors":"Davi Shunji Yahiro, Luis Felipe Leite da Silva, Giovane Leal Junior, Mouaz H Al-Mallah, Claudio Tinoco Mesquita","doi":"10.1016/j.nuclcard.2025.102279","DOIUrl":"https://doi.org/10.1016/j.nuclcard.2025.102279","url":null,"abstract":"<p><strong>Background: </strong>Myocardial blood flow (MBF) and Myocardial Flow Reserve (MFR) measurement is crucial for diagnosing and managing coronary artery disease and microvascular dysfunction. While Positron Emission Tomography (PET) is the gold standard, Cadmium Zinc Telluride (CZT) is more accessible. This systematic review and meta-analysis aim to compare the accuracy, and the systematic bias of MBF and MFR measurement using CZT compared to PET.</p><p><strong>Methods: </strong>We conducted a systematic review across multiple databases up to April 2024. The main outcomes were mean difference between MBF and MFR values obtained from PET and CZT, limits of agreement, and diagnostic performance. Risk of bias was assessed using the QUADAS-2 tool, and statistical analysis was conducted using random-effects models.</p><p><strong>Results: </strong>Eight studies, encompassing 268 patients, met the inclusion criteria. The mean difference for rest and stress myocardial blood flow between PET and CZT was 0.006 (95% CI: -0.088, 0.100) and 0.111 (95% CI: -0.418, 0.195) respectively. The myocardial flow reserve mean difference was 0.0178 (95% CI: -0.492, 0.135). Bland-Altman meta-analysis demonstrated a bias of 0.05 mL/min/g (95%CI: -1.08 to 1.24) for rest MBF, 0.13 mL/min/g for stress MBF (95%CI: -0.969 to 1.228), and 0.03 mL/min/g (95%CI: -0.999, 1.006) bias for MFR.. Diagnostic performance for detecting significant reductions in MBF and MFR on SPECT, using PET as the gold standard demonstrated sensitivity and specificity of 80.8% and 87.0% respectively.</p><p><strong>Conclusion: </strong>CZT MBF measurements demonstrated good agreement with PET, although a slight underestimation. While PET remains the preferred modality due to its superior performance, CZT represents a viable alternative when PET is unavailable. Future research should focus on standardizing CZT protocols.</p>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":" ","pages":"102279"},"PeriodicalIF":3.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Test-retest Reproducibility of Myocardial ^99mTc-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":"https://doi.org/10.1016/j.nuclcard.2025.102273","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":3.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Validation of [99mTc]Tc-HMDP SPECT/CT Myocardial Uptake Quantification for the Detection of ATTR Cardiomyopathy\".","authors":"Ayesha Parvaiz Malik, Urooj Fatima Parvez Malik, Javed Iqbal, Brijesh Sathian, Syed Muhammad Ali","doi":"10.1016/j.nuclcard.2025.102272","DOIUrl":"https://doi.org/10.1016/j.nuclcard.2025.102272","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":" ","pages":"102272"},"PeriodicalIF":3.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of ^99mtechnetium-PYP SPECT Visual Grade in Patients with Transthyretin Cardiac Amyloidosis on Stabilization Therapy.","authors":"Ardel J Romero Pabón, Olivier F Clerc, Sarah A M Cuddy, Shilpa Vijayakumar, Zhou Lan, Hanna K Gaggin, Marcelo F Di Carli, Rodney H Falk, Sharmila Dorbala","doi":"10.1016/j.nuclcard.2025.102275","DOIUrl":"https://doi.org/10.1016/j.nuclcard.2025.102275","url":null,"abstract":"<p><strong>Objective: </strong>The aim of our study was to evaluate the prognostic value of amyloid burden estimated by ^99mTechnetium-pyrophosphate SPECT (^99mTc-PYP-SPECT) visual grade in patients with transthyretin amyloid cardiomyopathy (ATTR-CM) receiving transthyretin (TTR) stabilization therapy.</p><p><strong>Methods: </strong>Our retrospective cohort study included 344 ATTR-CM participants receiving TTR stabilization therapy. ^99mTc-PYP-SPECT myocardial uptake was graded as 0, 1, 2 or 3, based on myocardial uptake that was either absent, less than, equal to, or greater than rib uptake, respectively. National Amyloidosis Center (NAC) stage was defined by NTpro-BNP (≤3000 pg/ml) and estimated glomerular filtration rate (≥45 mL/min/1.73m²) levels. The primary outcome was all-cause mortality. Kaplan-Meier survival and multivariable Cox regression analyses were performed.</p><p><strong>Results: </strong>Of 344 participants (median age 80 years), 88% were men, and 98% had ^99mTc-PYP-SPECT visual grade uptake 2 or 3. 76 participants (22.1%) died during follow-up (median 27 months). In Cox regression analysis adjusted for age, NAC stage, NYHA class, left ventricular (LV) mass index, LV ejection fraction, and ^99mTc-PYP-SPECT visual grade, only NAC stage (HR 4.01, p-value <0.001) and NYHA class (HR: 5.22, p-value = 0.011) strongly predicted mortality.</p><p><strong>Conclusions: </strong>In patients with ATTR-CM receiving TTR stabilization therapy, organ dysfunction evidenced by NAC stage and NYHA class, but not by amyloid burden on ^99mTc-PYP-SPECT visual grade, are strong predictors of mortality. Our results support a revision to ^99mTc-PYP visual grading 2 and 3 into a single grade positive. Future work is needed to evaluate whether amyloid burden measured by quantitative ^99mTc-PYP-SPECT offers prognostic value in ATTR-CM.</p>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":" ","pages":"102275"},"PeriodicalIF":3.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prevalence and Prognostic Impact of Additive Abnormal Stress Exercise Markers in Patients with Normal Stress Myocardial Perfusion Imaging.","authors":"Steven C Scherping, Syed M Ahmad, Stephanie M Katz, Nisha Hosadurg, Katirina R Guinto, James T McParland, Siddhartha S Angadi, Amit R Patel, Jamieson M Bourque","doi":"10.1016/j.nuclcard.2025.102267","DOIUrl":"https://doi.org/10.1016/j.nuclcard.2025.102267","url":null,"abstract":"<p><strong>Background: </strong>While the rate of ischemia on stress myocardial perfusion imaging (MPI) has decreased over the last two decades, many symptomatic patients remain at intermediate to high risk for cardiac events. Exercise workload, heart rate response, heart rate recovery, hemodynamic gain index, and blood pressure response to exercise have established prognostic value in isolation; however, the utility of these markers in patients with normal myocardial perfusion and no ischemic ECG ST-segment depression (normal stress MPI) is unknown.</p><p><strong>Methods: </strong>We performed a retrospective, single-center analysis of abnormal stress exercise markers in 892 patients who had a normal stress MPI from 2015-2017. We measured the prevalence and relative risk for death or non-fatal myocardial infarction (NFMI) associated with additive abnormal stress exercise markers.</p><p><strong>Results: </strong>The mean age of patients was 61 (55% male). Most subjects (82.6%) had possible cardiac symptoms. At least one abnormal marker was found in 65.1% patients, and 9.6% had three or more markers. After adjustment for traditional risk factors, there was a 36% stepwise increase in risk for events with each additional marker present, and patients with three or more markers were at the highest risk for events (HR 2.44 [1.09 - 5.48], p = 0.031).</p><p><strong>Conclusion: </strong>Patients with normal stress MPI have a high burden of abnormal stress exercise markers, which confer a stepwise increase in risk for adverse events. This prognostic information highlights an added value of exercise testing for risk stratification in patients with normal stress MPI and may suggest symptom etiology in the absence of ischemia.</p>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":" ","pages":"102267"},"PeriodicalIF":3.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serial ¹⁸F-Fluorodeoxyglucose Positron Emission Tomography to Assess the Efficacy of Infliximab in Steroid Refractory Cardiac Sarcoidosis.","authors":"Louise E Crowley, Ellen Jenkins, Akalanka Ranasinghe, Tamara Naneishvili, Mengshi Yuan, Khalid Hussain, Francisco Leyva-Leon, Anjali Crawshaw, William E Moody","doi":"10.1016/j.nuclcard.2025.102265","DOIUrl":"https://doi.org/10.1016/j.nuclcard.2025.102265","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":" ","pages":"102265"},"PeriodicalIF":3.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technical Evaluation of Immediate Back-to-Back Rest-Stress PET Scanning with ¹⁸F-Flurpiridaz.","authors":"Dan J Kadrmas, Brad J Kemp, Arkadiusz Sitek, Panithaya Chareonthaitawee","doi":"10.1016/j.nuclcard.2025.102268","DOIUrl":"https://doi.org/10.1016/j.nuclcard.2025.102268","url":null,"abstract":"<p><strong>Background: </strong>¹⁸F-flurpiridaz is the newest positron emission tomography myocardial perfusion tracer approved in the US for evaluating myocardial ischemia and infarction (Flyrcado™, GE HealthCare). The 110 minute half-life of ¹⁸F enables flurpiridaz to be made and shipped regionally; however, it also results in high levels of residual tracer activity for same-day rest/stress scanning. This study provides a technical evaluation of immediate back-to-back rest/stress flurpiridaz PET with no delay, using a commercially-available software medical device (mfiVerse™, MultiFunctional Imaging LLC) to correct for residual activity effects.</p><p><strong>Methods and results: </strong>Retrospectively-obtained separate-scan dynamic rest and pharmacologic stress flurpiridaz images in 11 subjects were digitally shifted and combined to model a 15 minute rest/stress procedure with rest scan from 0-8 min. and stress scan from 8-15 min., providing a paired-sample study design. Modeling of residual tracer effects included both distributed activity and stress effects upon residual arterial input. Residual activity biased mean stress pixel values and myocardial blood flow (MBF) by +31% and +64%, respectively, as compared to the reference stress images without residual activity. These biases were each reduced to less than 1% after residual activity correction. Linear regression analysis found that corrected stress pixel values (r=0.998) and MBF (r=0.994) closely matched reference stress values, both being equivalent to separate-scan values to less than half of test-retest variability (p<0.001). Summed Stress Scores averaged 2.5 points lower for uncorrected images vs. the reference images, and averaged 0.4 points lower after correction.</p><p><strong>Conclusions: </strong>Within the study limitations, these results demonstrate that rest and stress flurpiridaz PET images can be obtained immediately back-to-back without rest-stress delay when accurate correction for residual activity is performed.</p>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":" ","pages":"102268"},"PeriodicalIF":3.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}