Nuclear Medicine Communications最新文献

{"title":"Comparison of quantitative Krenning Scores with visual assessment in 99m Tc-EDDA/HYNIC-TOC SPECT-CT.","authors":"Alastair J Gemmell, Colin M Brown, Surajit Ray, Alexander Small","doi":"10.1097/MNM.0000000000001967","DOIUrl":"10.1097/MNM.0000000000001967","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study is to assess inter-observer variability of the Krenning Score for 99m Tc-EDDA/HYNIC-TOC single photon emission computed tomography (SPECT)-computed tomography (CT) images and compare against quantitative metrics obtained from tumour and physiological uptake measurements.</p><p><strong>Methods: </strong>Thirty-two patients with 117 lesions visible on 99m Tc-EDDA/HYNIC-TOC SPECT-CT were scored by two expert observers using the Krenning Score. Five observers with less extensive experience also scored the lesions on visual assessment. Inter-observer agreement and comparison to the expert consensus was tested. Three observers made quantitative measurements of the lesions and physiological uptake, with intra-observer and inter-observer variation investigated. Assessment of agreement between quantitative metrics and the expert visual consensus was also made.</p><p><strong>Results: </strong>Inter-observer agreement for visual assessment was 44.3% for proportions of agreement and 0.576 for Fleiss' Kappa, whilst for the best-performing quantitative metric the inter-observer Fleiss' Kappa was equal to 1. The agreement with expert consensus for the best-performing visual observer was 89.8% for percentage of agreement and 0.914 for Cohen's Kappa, similar to the best-performing quantitative metric (a derived quantitative Krenning Score) at 86.4% and κ  = 0.877. Standardised uptake value maximum (SUV max ) also showed similar levels of agreement at 85.1% and κ  = 0.871.</p><p><strong>Conclusion: </strong>A derived quantitative Krenning Score, or alternatively SUV max , can provide similar levels of agreement with an expert consensus Krenning Score as visual assessment, with reduced inter-observer variability. Quantification can deliver greater consistency in scoring of 99m Tc-EDDA/HYNIC-TOC images over visual assessment, an important factor when imaging is used to determine patient eligibility for peptide receptor radiotherapy.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"515-522"},"PeriodicalIF":1.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516162","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":"99m Technetium-pyrophosphate SPECT/CT with novel semiautomated quantification has excellent diagnostic accuracy for detecting cardiac transthyretin amyloidosis.","authors":"Saxby Brown, Fiona Kwok, Scott Evans, Paul Geenty, Liza Thomas, George Larcos, David Farlow","doi":"10.1097/MNM.0000000000001972","DOIUrl":"10.1097/MNM.0000000000001972","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the diagnostic accuracy of a novel semiautomated method to calculate relative myocardial wall uptake (RCU) of 99m Technetium-pyrophosphate SPECT/CT in suspected cardiac transthyretin amyloidosis (ATTR).</p><p><strong>Methods: </strong>Prospective analysis of 108 participants with suspected ATTR. Using novel software, we quantified radiopharmaceutical uptake in the wall of each chamber of the heart at 3 h, calculating RCU for combined ventricular (RCU-V) and whole-heart (RCU-W) measures as a ratio over physiological blood-pool activity. Optimal RCU cut-off ratios were determined using a documented clinical diagnosis of ATTR amyloidosis as the reference standard.</p><p><strong>Results: </strong>The RCU-V method with a cut-off ratio of 1.2 achieved a sensitivity of 100% [95% confidence interval (CI): 90-100%], specificity of 99% (95% CI: 95-100%), and accuracy of 99% (95% CI: 96-100%). The RCU-W method required a higher cut-off ratio of 1.4 to achieve a comparable specificity of 99%.</p><p><strong>Conclusion: </strong>This novel SPECT/CT quantification software using the RCU-V method significantly improves diagnostic accuracy for cardiac ATTR and represents an advance compared to existing planar nuclear imaging assessment techniques.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"533-538"},"PeriodicalIF":1.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606003","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":"Predicting the spread through air spaces in lung adenocarcinoma from preoperative 18 F-FDG PET/CT radiomics.","authors":"Xiaohui Chen, Hongliang Qi, Yijin Zou, Ye Chen, Hanwei Li, Debin Hu, Li Jiang, Meng Wang, Li Chen, Hongwen Chen, Hubing Wu","doi":"10.1097/MNM.0000000000001975","DOIUrl":"10.1097/MNM.0000000000001975","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop an effective radiomics-clinical model to preoperatively discriminate the spread through air spaces (STAS) in lung adenocarcinoma (ADC).</p><p><strong>Methods: </strong>Data from 192 ADC patients were enrolled, with 2/3 ( n  = 128) allocated as the training cohort and the remaining 1/3 ( n  = 64) designated as the validation cohort. A total of 2212 radiomics features were extracted from PET/computed tomography (PET/CT) images. The least absolute shrinkage and selection operator regression method was applied to select features. Logistic regression was used to construct radiomics and clinical models. Finally, a radiomics-clinical model that combined clinical with radiomics features was developed. The models were evaluated by receiver operating characteristic (ROC) curve and decision curve analysis.</p><p><strong>Results: </strong>The area under the ROC curve (AUC) of the radiomics-clinical model was 0.924 (95% confidence interval, 0.878-0.969) in the training cohort and 0.919 (0.833-1.000) in the validation cohort. The AUC of the radiomics model was 0.885 (0.825-0.945) in the training cohort and 0.877 (0.766-0.988) in the validation cohort. The AUC of the clinical model was 0.883 (0.814-0.951) in the training cohort and 0.896 (0.7706-1.000) in the validation cohort. The decision curve analysis indicated its clinical usefulness.</p><p><strong>Conclusion: </strong>The PET/CT-based radiomics-clinical model achieved satisfactory performance in discriminating the STAS in ADC preoperatively.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"570-578"},"PeriodicalIF":1.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649522","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":"Clinical combined PET/CT radiomics model prediction of benefit from platinum-based chemotherapy and chemoradiotherapy in patients with small cell lung cancer.","authors":"Mengye Peng, Xinyue Yang, Yanmei Wang, Liangqin Zhou, Fan Ge, Shijia Liu, Wei Liu, Liang Cheng, Kezheng Wang","doi":"10.1097/MNM.0000000000001971","DOIUrl":"10.1097/MNM.0000000000001971","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate a clinical combined radiomics model for predicting the treatment response and long-term survival prognosis of small cell lung cancer (SCLC) patients receiving platinum-based chemotherapy, as well as survival outcomes following chemoradiotherapy.</p><p><strong>Methods: </strong>A total of 98 SCLC patients treated with platinum-based first-line chemotherapy were included in this study. Five prediction models for assessing the short-term efficacy of platinum-based first-line chemotherapy were developed using a logistic regression algorithm. The performance of the models was assessed by calculating the area under the curve of the receiver operating characteristic curves. For predicting progression-free survival (PFS) and overall survival in the platinum-based chemotherapy group and the chemoradiotherapy group, the optimal cutoff value was determined using X-tile software. Kaplan-Meier survival curves were plotted, and the log-rank test was used to compare survival outcomes.</p><p><strong>Results: </strong>Among the five models for predicting short-term efficacy, the clinical combined positron emission tomography/computed tomography (PET/CT) radiomics model performed the best, achieving areas under the curve of 0.832 and 0.833 for the training and test sets, respectively. The Kaplan-Meier survival analysis indicated that both the high-scoring Combine group and high-scoring PET/CT group were significantly associated with worse PFS and worse overall survival in the platinum-only chemotherapy group. Additionally, the high-scoring CT group was significantly associated with worse PFS in the chemoradiotherapy group.</p><p><strong>Conclusion: </strong>The clinical combined PET/CT radiomics model can noninvasively and accurately predict the response to platinum-based treatments in SCLC as well as long-term survival prognosis, which can contribute to personalized treatment strategies and guide precision therapy for SCLC patients.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"558-569"},"PeriodicalIF":1.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625856","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 visual interpretation of [I-123] FP-CIT SPECT scans versus reference-based quantitative analysis utilizing a Japanese normal database.","authors":"Ryo Yamakuni, Shiro Ishii, Kenji Fukushima, Takeyasu Kakamu, Masanori Yusa, Katsuyuki Kikori, Tensho Yamao, Noriyuki Takahashi, Hirofumi Sekino, Shuntaro Itagaki, Itaru Miura, Hiroshi Ito","doi":"10.1097/MNM.0000000000001968","DOIUrl":"10.1097/MNM.0000000000001968","url":null,"abstract":"<p><strong>Objective: </strong>Dopamine transporter single-photon emission computed tomography (DAT-SPECT) plays an important role in diagnosing parkinsonism. Recently, a reference-based quantitative analysis utilizing a Japanese normal database for DAT-SPECT was developed. This study aimed to investigate the frequency and trends of cases wherein the analysis- and physician-based diagnoses diverged.</p><p><strong>Methods: </strong>Two physicians performed an interpretation task twice on 195 DAT-SPECT scans. After assessing intra- and intertester agreements, disagreements were resolved by consensus. For the reference-based quantitative analysis, the calibrated specific binding ratio (cSBR), calibrated asymmetry index (cAI), and Z-scores were measured. Images were grouped according to physician consensus and the negative-positive difference from thresholds (Z-score of less than -2.0 and/or cAI of more than 12.22) as follows: group 1 (physician, normal; quantitative analysis, normal; n  = 70), group 2 (abnormal; normal; n  = 4), group 3 (normal; abnormal; n  = 31), and group 4 (abnormal; abnormal; n  = 90).</p><p><strong>Results: </strong>Median cSBRs and Z-scores decreased in order from group 1 to group 4. Median cAI values increased in the order of groups 1, 3, 2, and 4. Significant differences were observed between groups 1 and 2 for cSBRs and cAIs; groups 2 and 3 for Z-scores; groups 2 and 4 for cSBRs and Z-scores; and groups 1 and 3, 1 and 4, and 3 and 4 for all parameters (Kruskal-Wallis and Steel-Dwass tests).</p><p><strong>Conclusion: </strong>In approximately 18% of cases, the visual interpretation of physicians diverged from the reference-based quantitative analysis based on a Japanese normal database. It is crucial to appropriately utilize DAT-SPECT reference-based quantitative analysis as a diagnostic aid.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"523-532"},"PeriodicalIF":1.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492554","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":"Contribution of tubarial salivary gland function detected through 68 Ga-prostate-specific membrane antigen PET/computed tomography to total salivary gland function.","authors":"İhsan Kaplan, Ömer Yeprem, Halil Kömek, Ferat Kepenek, Yunus Güzel, Hüseyin Karaoğlan, Mehmet Serdar Yildirim, Veysi Şenses, Ridvan Kiliç, Fulya Kaya İpek, Emine Budak, Ahmet Yanarateş, Canan Can","doi":"10.1097/MNM.0000000000001970","DOIUrl":"10.1097/MNM.0000000000001970","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine the contribution of tubarial salivary glands to total salivary gland function using quantitative parameters obtained from 68 Ga-prostate-specific membrane antigen (PSMA) PET/computed tomography (PET/CT), including salivary gland volume (SV) and salivary gland function (SF).</p><p><strong>Method: </strong>This retrospectively designed study included 102 patients with prostate cancer (PCa) who had undergone 68 Ga-PSMA PET/CT for staging purposes between January 2022 and December 2023. Patients with missing data, those with tumors in the head and neck region, those who received radiotherapy to the head and neck region, those who underwent surgery in the head and neck region, those with any salivary gland-related disease, those previously treated with radioactive iodine, and those who received lutetium-177 ( 177 Lu) therapy were excluded from the study.</p><p><strong>Results: </strong>All 102 patients included in the study were male and diagnosed with PCa. The mean age of the patients was calculated as 72.53 ± 7.58 years. Patients' tubarial SV% and tubarial SF% values were calculated as 7.76 ± 4.01 and 2.58 ± 1.34, respectively. The percentage volume of tubarial glands was found to be statistically significantly higher than that of sublingual glands ( P < 0.001, Wilcoxon signed-rank test). No statistical difference, however, was observed in their contributions to total function ( P = 0.506).</p><p><strong>Conclusion: </strong>When examining the volume ratios of salivary glands showing PSMA expression, it was found that the tubarial salivary glands had a higher volumetric ratio but a lower contribution to total function. We recommend considering these ratios when administering treatments that affect salivary gland functions.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"553-557"},"PeriodicalIF":1.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492774","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 prognostic value of left ventricular diastolic dyssynchrony combined with myocardial perfusion, systolic dyssynchrony, and cardiovascular risk factors in patients with normal left ventricular ejection fraction.","authors":"Jingwen Wang, Bao Liu, Feifei Zhang, Jianfeng Wang, Wenji Yu, Yurui Hu, Zhimin Yang, Peng Wan, Xiaoyu Yang, Yuetao Wang","doi":"10.1097/MNM.0000000000001969","DOIUrl":"10.1097/MNM.0000000000001969","url":null,"abstract":"<p><strong>Objective: </strong>Major adverse cardiovascular events (MACE) still occur in the normal left ventricular ejection fraction (LVEF) patients with coronary artery disease (CAD). Currently, there are no studies related to the prognostic value of left ventricular diastolic dyssynchrony (LVDD) in combination with perfusion, systolic dyssynchrony, and cardiovascular risk factors in patients with normal LVEF. Therefore, we aimed to investigate the incremental prognostic value of LVDD in patients with normal LVEF and to establish a model to predict MACE.</p><p><strong>Methods: </strong>This study included 239 suspected or known CAD patients with a normal LVEF who underwent gated single-photon emission computerized tomography myocardial perfusion imaging. Clinical data such as age, sex, and cardiovascular risk factors were collected. Myocardial perfusion, and left ventricular dyssynchrony parameters were assessed using QPS and Emory Toolbox software, respectively. The least absolute shrinkage and selection operator and multivariable Cox regression were used to select the variables.</p><p><strong>Results: </strong>The subjects were followed up for a total of 73.2 ± 16.4 months and MACE occurred in 28 patients. In multivariate Cox regression, rest diastolic bandwidth (BW) was closely related to MACE [hazard ratio (95% confidence interval), 10.78 (1.65-70.35); P  = 0.013]. The C-index of the model was increased from 0.748 to 0.783 by increasing the rest diastolic BW on the basis of summed difference score (SDS), stress systolic SD, age, hypertension, and chest pain ( P  < 0.001). A final model for predicting MACE was constructed based on age, hypertension, chest pain, SDS, stress systolic SD, and rest diastolic BW. The C-index of the model was 0.783, and the area under the curves of the model predicting the occurrence of 3-year and 5-year MACE events were 0.766 and 0.827, respectively. The calibration curve showed a good calibration of the model.</p><p><strong>Conclusion: </strong>LVDD is associated with MACE in patients with normal LVEF. In addition, based on SDS, stress systolic SD, age, hypertension, and chest pain, rest diastolic BW had an incremental predictive value for MACE.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"545-552"},"PeriodicalIF":1.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493049","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 reprojected 'pseudoplanar' bone SPECT/CT and planar bone scintigraphy for the detection and localization of foot and ankle osteoarthritis.","authors":"Klaus Strobel, Hannes Grünig, Thiago Lima, David Bärtschi, Tatjana Leike, Nina Lampe, Ujwal Bhure","doi":"10.1097/MNM.0000000000001974","DOIUrl":"10.1097/MNM.0000000000001974","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the performance of pseudoplanar (PP) images reprojected from bone single photon emission computed tomography/computed tomography (SPECT/CT) against 'real' planar bone scintigraphy for the assessment of localization and grading of radiotracer uptake of active osteoarthritic joints in the foot and ankle. Noninferiority of PP images would shorten the protocol substantially.</p><p><strong>Methods: </strong>Late-phase real planar (RP) and SPECT/CT reconstructed PP images of 96 feet in 48 patients (22 women, 26 men, median age: 49 years, interquartile range: 34-67 years) with foot and ankle osteoarthritis were independently evaluated by three different readers. Presence, localization, and uptake grade (grade 1: mild, 2: moderate, and 3: high uptake of the radiotracer) of the active osteoarthritic joints were assessed. SPECT/CT served as a reference standard, and maximum standardized uptake value (SUV max ) was measured for all active foot and ankle joints.</p><p><strong>Results: </strong>Overall, 123 of 3168 joints in 48 patients had active osteoarthritis (OA) on SPECT/CT. The most frequently affected joints were the tarsometatarsal ( n  = 29), upper ankle (27), lower ankle (23), and talonavicular (15) joints. The mean SUV max of all active joints was 11.9 ± 7.5. The rate of correct detection and localization of active joints for the three readers was 77/82/85% for RP and 80/81/81% for PP, without significant difference. There was substantial agreement between RP and PP images among all the readers (R1 : 0.70, R2 : 0.76, R3 : 0.74). There was a significant correlation for visual uptake grading among all the readers for RP and PP images ( P  = 0.001).</p><p><strong>Conclusion: </strong>Planar images can be replaced by reconstructed PP images, leading to a substantially time-saving foot and ankle bone SPECT/CT protocol, as PP images are noninferior to planar images for the detection, localization, and grading of osteoarthritis. We expect that further technical advances coupled with artificial intelligence will improve the performance of hybrid imaging in nononcologic indications.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"539-544"},"PeriodicalIF":1.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606009","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":"PET imaging of atherosclerosis: artificial intelligence applications and recent advancements.","authors":"Shaheer Rizwan, Cyrus Ayubcha, Omar Al-Daoud, Mamdouh Al-Atout, Raisa Amiruddin, Thomas J Werner, Abass Alavi","doi":"10.1097/MNM.0000000000001973","DOIUrl":"10.1097/MNM.0000000000001973","url":null,"abstract":"<p><p>PET imaging has become a valuable tool for assessing atherosclerosis by targeting key processes such as inflammation and microcalcification. Among available tracers, 18F-sodium fluoride has demonstrated superior performance compared to 18F-fluorodeoxyglucose, particularly in detecting coronary artery disease. However, the role of other tracers remains underexplored, requiring further validation. Emerging technologies such as artificial intelligence show potential in enhancing diagnostic speed and accuracy. Furthermore, the integration of the Alavi-Carlsen Calcification Score offers a novel approach to evaluating global disease burden, presenting a more clinically applicable method for predicting outcomes. Techniques such as total-body PET provide faster and more comprehensive imaging of the entire vascular system with reduced radiation exposure, representing a significant advancement in early detection and intervention. The combination of molecular imaging and advanced computational tools may revolutionize the management of atherosclerosis, facilitating earlier identification of at-risk individuals and improving long-term cardiovascular outcomes.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"503-514"},"PeriodicalIF":1.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719870","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":"Assessment of perfusion on ventilation/perfusion scan after balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension: expert opinion versus guidance by reference chart.","authors":"Diederik P Staal, Mitch C J van Thor, Ruth G M Keijsers, Monique M C van Buul, Joyce Peper, Daniel A F van den Heuvel, Sanne Boerman, Johannes J Mager, Martijn C Post","doi":"10.1097/MNM.0000000000001996","DOIUrl":"https://doi.org/10.1097/MNM.0000000000001996","url":null,"abstract":"<p><strong>Objective: </strong>Balloon pulmonary angioplasty (BPA) is frequently used in chronic thromboembolic pulmonary hypertension (CTEPH)/chronic thromboembolic pulmonary disease (CTED). Nevertheless, noninvasive pulmonary perfusion imaging after BPA is scarce. In this study, change in perfusion on ventilation/perfusion (V/Q) scan after BPA was assessed and correlated with clinical outcomes.</p><p><strong>Methods: </strong>Retrospectively, all consecutive patients with CTEPH/CTED patients who completed BPA and received planar V/Q scans baseline and 6 months follow-up were included. Perfusion was evaluated using gestalt interpretation and semiquantitative calculation of the pulmonary vascular obstruction (PVO) index, with obligatory use of the lung segment reference chart. Interobserver variability was assessed for both methods, and the correlation between PVO index and clinical parameters was tested.</p><p><strong>Results: </strong>Thirty-three patients with CTEPH/CTED (mean age: 60.4 ± 14.7 years, 70% female) underwent 127 BPA procedures. Gestalt interpretation showed improved perfusion in 79% of all patients, and PVO index decreased significantly compared with baseline (45 ± 15-35 ± 15%; P < 0.001). The gestalt method showed a weak level of agreement (k = 0.32; P = 0.06), and the PVO method showed a moderate to strong reliability (R2 : 0.71, P < 0.001). The PVO index showed a significant (P < 0.001) but weak correlation with log N-terminal probrain natriuretic peptide, mean pulmonary artery pressure, and pulmonary vascular resistance (R2 : 0.26, 0.24, and 0.18, respectively).</p><p><strong>Conclusion: </strong>Perfusion on V/Q scan significantly improved after BPA in patients with CTEPH/CTED. Semiquantitative calculation of PVO was more reliable in comparison to gestalt interpretation, however, clinical parameters showed only a weak correlation with the PVO index.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151350","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}