Journal of Nuclear Cardiology最新文献

{"title":"Test–retest reproducibility of myocardial 99mTc-HMDP uptake quantification by SPECT-CT in suspected transthyretin cardiac amyloidosis","authors":"Damien Legallois MD, PhD ,&nbsp;Lucas Turcan MD ,&nbsp;Denis Agostini MD, PhD ,&nbsp;Alain Manrique MD, PhD","doi":"10.1016/j.nuclcard.2025.102273","DOIUrl":"10.1016/j.nuclcard.2025.102273","url":null,"abstract":"<div><h3>Background</h3><div>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 single-photon emission computed tomography–computed tomography (SPECT-CT) may overcome these limitations by enabling quantitative assessment, but data on test–retest reproducibility are lacking.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the test–retest, intraobserver and interobserver reproducibility of cardiac amyloid quantification in suspected ATTR-CA using whole-body cadmium zinc telluride SPECT-CT.</div></div><div><h3>Methods</h3><div>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 value (SUVmax), mean standardized uptake value (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).</div></div><div><h3>Results</h3><div>Intraobserver and interobserver reproducibility was excellent for all metrics (CCC ≥.99). Test–retest reproducibility demonstrated substantial agreement for SUVmean (CCC: .79) and almost perfect agreement for SUVmax (CCC: .81), %ID (CCC: .88), and CAA (CCC: .93). All parameters correlated with the Perugini score. Test–retest reliability was high across metrics, with ICC values of .80-.97.</div></div><div><h3>Conclusions</h3><div>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.</div></div><div><h3>Clinical trial registration</h3><div>NCT04535349.</div></div>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"51 ","pages":"Article 102273"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","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":"The Perugini grades after 20 years: Time for a modern framework","authors":"Brett W. Sperry MD ,&nbsp;Wael A. Jaber MD","doi":"10.1016/j.nuclcard.2025.102469","DOIUrl":"10.1016/j.nuclcard.2025.102469","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"51 ","pages":"Article 102469"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859283","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":"Normal stress, no rest: Why stress-only single-photon emission computed tomography deserves to be the new standard","authors":"Alan Rozanski MD ,&nbsp;Daniel Berman MD","doi":"10.1016/j.nuclcard.2025.102445","DOIUrl":"10.1016/j.nuclcard.2025.102445","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"51 ","pages":"Article 102445"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091939","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":"CME instructions: Prognostic value of 99mtechnetium-pyrophosphate single-photon emission computed tomography visual grade in patients with transthyretin cardiac amyloidosis on stabilization therapy","authors":"","doi":"10.1016/j.nuclcard.2025.102474","DOIUrl":"10.1016/j.nuclcard.2025.102474","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"51 ","pages":"Article 102474"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098324","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 MBBS ,&nbsp;Urooj Fatima Parvez Malik MBBS ,&nbsp;Javed Iqbal RN, MBA ,&nbsp;Brijesh Sathian MD[AM], PhD, FRSS, FCEA, FCMRA ,&nbsp;Syed Muhammad Ali MBBS, MRCS, FCPS, EBSQ, FACS","doi":"10.1016/j.nuclcard.2025.102272","DOIUrl":"10.1016/j.nuclcard.2025.102272","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"51 ","pages":"Article 102272"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","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":"Total-body positron emission tomography: Investigating mechanisms in cardiovascular-kidney-metabolic syndrome","authors":"Jenifer M. Brown MD ,&nbsp;Daniel M. Huck MD, MPH","doi":"10.1016/j.nuclcard.2025.102299","DOIUrl":"10.1016/j.nuclcard.2025.102299","url":null,"abstract":"<div><div>Total-body positron emission tomography (PET) is an emerging tool whose potential is being actively explored to interrogate multisystem biologic processes. Cardiovascular-kidney-metabolic (CKM) syndrome is increasingly recognized as a multidimensional disease driving cardiovascular and renal morbidity and mortality, but the underlying pathologic mechanisms remain incompletely understood. As mechanistic investigation moves to understand systems physiology in CKM syndrome, the ability to simultaneously assess shared biologic processes and crosstalk between the cardiovascular and renal systems is a unique strength of total-body PET. Total-body PET-computed tomography (PET-CT) systems can leverage existing and novel radiotracers to evaluate perfusion, fibrosis, metabolism, inflammation, and body composition. This review summarizes evidence for the assessment of cardiovascular and renal tissues with PET and discusses potential future applications for understanding mechanistic interactions between these interrelated systems using total-body PET, which could ultimately be applied to the development of targeted therapies for the benefit of patients with CKM disorders.</div></div>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"51 ","pages":"Article 102299"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584100","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 99mTc-pyrophosphate uptake in patients with suspected transthyretin cardiac amyloidosis","authors":"Tomohi Ajima MD ,&nbsp;Tadao Aikawa MD, PhD ,&nbsp;Toshinori Saitou RT ,&nbsp;Yuya Matsue MD, PhD ,&nbsp;Shinichiro Fujimoto MD, PhD ,&nbsp;Kazunori Omote MD, PhD ,&nbsp;Tohru Minamino MD, PhD","doi":"10.1016/j.nuclcard.2025.102452","DOIUrl":"10.1016/j.nuclcard.2025.102452","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to evaluate the prognostic value of myocardial ^99mTc-pyrophosphate (PYP) uptake in patients undergoing PYP imaging for suspected transthyretin cardiac amyloidosis (ATTR-CA).</div></div><div><h3>Methods</h3><div>A retrospective analysis of 301 consecutive patients who underwent PYP imaging for suspected ATTR-CA was performed. Myocardial PYP uptake was graded visually using the Perugini classification (grade 0-3) and quantified by the heart-to-contralateral lung uptake (H/CL) ratio. The primary outcome was combined cardiac death and documented fatal ventricular arrhythmias (ventricular fibrillation [VF] and sustained ventricular tachycardia [VT] lasting &gt;30 seconds).</div></div><div><h3>Results</h3><div>Among the 301 patients, 90 had positive myocardial PYP uptake on SPECT. During a median follow-up of 668 days (interquartile range, 186-868 days), 36 patients died, including 13 cardiac deaths. Fatal ventricular arrhythmias were documented in 6 patients (2 aborted VF and 4 sustained VT). The primary outcome occurred in 8 of 211 (4%) patients with negative PYP SPECT and in 10 of 90 (11%) patients with positive PYP SPECT. Kaplan–Meier analyses showed a significantly higher incidence of the primary outcome in patients with positive PYP SPECT than in those without (P=.018). In contrast, all-cause mortality did not differ significantly between the two groups (P=.36). Multivariable Cox proportional hazards regression analyses showed that PYP SPECT positivity was an independent predictor of the primary outcome in patients with suspected ATTR-CA (adjusted hazard ratio: 2.86 [95% confidence interval: 1.10-7.41]; P =.031).</div></div><div><h3>Conclusions</h3><div>Significant myocardial PYP uptake was associated with an increased risk of adverse cardiac events in patients with suspected ATTR-CA.</div></div>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"51 ","pages":"Article 102452"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784476","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":"Empowering patients and providers: A new dimension of best practice in nuclear cardiology","authors":"Marcelo F. Di Carli MD, MASNC","doi":"10.1016/j.nuclcard.2025.102483","DOIUrl":"10.1016/j.nuclcard.2025.102483","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"51 ","pages":"Article 102483"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091997","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-pyrophosphate single-photon emission computed tomography visual grade in patients with transthyretin cardiac amyloidosis on stabilization therapy","authors":"Ardel J. Romero Pabón MD ,&nbsp;Olivier F. Clerc MD, MPH ,&nbsp;Sarah A.M. Cuddy MD ,&nbsp;Shilpa Vijayakumar MD, MPH ,&nbsp;Zhou Lan PhD ,&nbsp;Hanna K. Gaggin MD, MPH ,&nbsp;Marcelo F. Di Carli MD ,&nbsp;Rodney H. Falk MD ,&nbsp;Sharmila Dorbala MD, MPH","doi":"10.1016/j.nuclcard.2025.102275","DOIUrl":"10.1016/j.nuclcard.2025.102275","url":null,"abstract":"<div><h3>Background</h3><div>The aim of our study was to evaluate the prognostic value of amyloid burden estimated by technetium-pyrophosphate single-photon emission computed tomography (^99mTc-PYP-SPECT) visual grade in patients with transthyretin (ATTR) amyloid cardiomyopathy (ATTR-CM) receiving TTR stabilization therapy.</div></div><div><h3>Methods</h3><div>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 absent, less than, equal to, or greater than rib uptake, respectively. National Amyloidosis Center (NAC) stage was defined by N-terminal pro B-type natriuretic peptide (≤3000 pg/mL) and estimated glomerular filtration rate (≥45 mL/min/1.73 m²) levels. The primary outcome was all-cause mortality. Kaplan-Meier survival and multivariable Cox regression analyses were performed.</div></div><div><h3>Results</h3><div>Of the 344 participants (median age: 80 years), 88% were men and 98% had a ^99mTc-PYP-SPECT visual grade uptake of 2 or 3. Seventy-six participants (22.1%) died during follow-up (median: 27 months). In the Cox regression analysis adjusted for age, NAC stage, New York Heart Association (NYHA) class, left ventricular (LV) mass index, LV ejection fraction, and ^99mTc-PYP-SPECT visual grade, only NAC stage (hazard ratio [HR]: 4.01, <em>P</em> value &lt;.001) and NYHA class (HR: 5.22, <em>P</em> value = .011) strongly predicted mortality.</div></div><div><h3>Conclusions</h3><div>In patients with ATTR-CM receiving TTR stabilization therapy, organ dysfunctions 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.</div></div>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"51 ","pages":"Article 102275"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","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 case for serial quantitative cardiac amyloid radionuclide imaging – will nuclear cardiology continue to transform care in transthyretin cardiac amyloidosis?","authors":"Shivda Pandey MBBS FASNC","doi":"10.1016/j.nuclcard.2025.102446","DOIUrl":"10.1016/j.nuclcard.2025.102446","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"51 ","pages":"Article 102446"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091964","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}