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, Lucas Turcan, Denis Agostini, Alain Manrique","doi":"10.1016/j.nuclcard.2025.102273","DOIUrl":"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 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.</p><p><strong>Objectives: </strong>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.</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 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).</p><p><strong>Results: </strong>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.</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":"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-pyrophosphate single-photon emission computed tomography 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":"10.1016/j.nuclcard.2025.102275","url":null,"abstract":"<p><strong>Background: </strong>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.</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 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.</p><p><strong>Results: </strong>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, P value <.001) and NYHA class (HR: 5.22, P value = .011) strongly predicted mortality.</p><p><strong>Conclusions: </strong>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.</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":"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 positron emission tomography scanning with ¹⁸F-flurpiridaz.","authors":"Dan J Kadrmas, Brad J Kemp, Arkadiusz Sitek, Panithaya Chareonthaitawee","doi":"10.1016/j.nuclcard.2025.102268","DOIUrl":"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 minutes 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 positron emission tomography (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 to 8 minutes and stress scan from 8 to 15 minutes, providing a paired-sample study design. The 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 with 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 = .998) and MBF (r = .994) closely matched reference stress values, both being equivalent to separate-scan values to less than half of test-retest variability (P < .001). Summed stress scores averaged 2.5 points lower for uncorrected images versus the reference images, and averaged .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}

{"title":"⁸²Rb positron emission tomography myocardial blood flow quantification: Influence of arterial input curve quality on diagnostic accuracy.","authors":"Hidesato Fujito, Mark Lemley, Valerie Builoff, Wenhao Zhang, Keiichiro Kuronuma, Giselle Ramirez, Aditya Killekar, Joanna X Liang, Paul Kavanagh, Mark C Hyun, Sean W Hayes, Louise E J Thomson, John D Friedman, Serge D Van Kriekinge, Marcelo F Di Carli, Damini Dey, Daniel S Berman, Piotr J Slomka","doi":"10.1016/j.nuclcard.2025.102270","DOIUrl":"10.1016/j.nuclcard.2025.102270","url":null,"abstract":"<p><strong>Background: </strong>We investigated whether the shape of arterial blood input curves affects the diagnostic performance of myocardial blood flow (MBF) on rubidium-82 (⁸²Rb) positron emission tomography (PET) myocardial perfusion imaging (MPI) for obstructive coronary artery disease (CAD).</p><p><strong>Methods and results: </strong>We retrospectively enrolled 386 patients without prior CAD who underwent ⁸²Rb PET-MPI and invasive coronary angiography within 6 months, from 2010 to 2018. Abnormal shapes of stress left atrial blood pool (BP) time activity curve were characterized into five categories based on visual/quantitative assessment: (1) low stress/rest peak ratio (SRPR), (2) slow activity rise, (3) slow activity decline, (4) broad peak and (5) multiple peaks. The SRPR was defined as the ratio of peak count value on the stress BP activity by rest BP activity. A low SRPR was defined as one below the median value (0.82). We compared the diagnostic performance of stress MBF and myocardial flow reserve for detecting obstructive CAD (≥70% stenosis) using area under the curve (AUC) analysis.</p><p><strong>Results: </strong>Among the five abnormal categories, the AUC of stress MBF in the low SRPR group (n = 193) was lower than in the normal SRPR group (n = 193) in per-patient (.67 [.59-.74] vs. .78 [.70-.84], P = .0499, respectively) and per-vessel analyses (.68 [.63-0.73] vs. .75 [.71-.79], P = .0352, respectively). The AUC in slow activity rise group (n = 167) for stress MBF was lower than in others in per-vessel analysis (n = 219) (.68 [.62-.72] vs. .75 [.70-.79], P = .0270). Other abnormal profiles showed no significant differences (all P > .05).</p><p><strong>Conclusions: </strong>Low SRPR and slow activity rise were associated with reduced diagnostic performance of stress MBF.</p>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":" ","pages":"102270"},"PeriodicalIF":3.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258279","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":"Priming with specific context improves large language model performance on nuclear cardiology board preparation test.","authors":"Waseem Hijazi, Valerie Builoff, Aditya Killekar, Aakash Shanbhag, Robert J H Miller, Damini Dey, Joanna X Liang, Kathleen Flood, Daniel Berman, Jamieson M Bourque, Lawrence M Phillips, Panithaya Chareonthaitawee, Piotr J Slomka","doi":"10.1016/j.nuclcard.2025.102269","DOIUrl":"10.1016/j.nuclcard.2025.102269","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":" ","pages":"102269"},"PeriodicalIF":3.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258280","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":"Benefit of 82-Rubidium Positron Emission Tomography for risk stratification in a patient with Intrapericardial diaphragmatic hernia","authors":"Banu SathyaMurthi MBBS, MRCP, FRCR,&nbsp;Sruthi Sarish MSc, RSO certified,&nbsp;Muhammad Arsalan Khan MBBS, MRCP, CBNC,&nbsp;Parthiban Arumugam MBBS, FRCP, MSc","doi":"10.1016/j.nuclcard.2024.102070","DOIUrl":"10.1016/j.nuclcard.2024.102070","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"48 ","pages":"Article 102070"},"PeriodicalIF":3.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622255","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":"AI-driven quantification in 18F-fluorodeoxyglucose positron emission tomography imaging for cardiac sarcoidosis: A step toward objectivity and reproducibility","authors":"Osamu Manabe MD, PhD","doi":"10.1016/j.nuclcard.2025.102224","DOIUrl":"10.1016/j.nuclcard.2025.102224","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"48 ","pages":"Article 102224"},"PeriodicalIF":3.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241399","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}