{"title":"Comparative post-therapeutic dosimetry between 2D planar-based and hybrid-based methods for personalized Lu-177 treatment","authors":"Wuri Handayani, Maythinee Chantadisai, Benchamat Phromphao, Nut Noipinit, Panya Pasawang, Kitiwat Khamwan","doi":"10.1007/s12149-024-01960-2","DOIUrl":"10.1007/s12149-024-01960-2","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aims to compare the calculated absorbed dose in target organs and tumors obtained using the different imaging protocols and the calculation methodologies implemented by HERMES HybridViewer dosimetry software for <sup>177</sup>Lu-PSMA I&T and <sup>177</sup>Lu-DOTATATE therapy.</p><h3>Methods</h3><p>Multiple time-point whole-body planar images and one SPECT/CT image were acquired from 18 patients including <sup>177</sup>Lu-PSMA I&T (13 patients) and <sup>177</sup>Lu-DOTATATE treatment (5 patients) after administration of 3.80–8.58 GBq injected activity. The regions of interest were drawn in the whole body, kidneys, liver, urinary bladder, salivary glands, and tumors to determine the time-integrated activity (TIA) in source organs. Absorbed doses in target organs were calculated according to the Medical Internal Radiation Dose (MIRD) scheme using the HERMES HybridViewer dosimetry integrated with OLINDA/EXM V.2.1 that utilizes the non-uniform rational B-splines (NURBS) for computational digital phantom.</p><h3>Results</h3><p>The planar-based dosimetry showed a higher dose per injected activity compared to the hybrid-based dosimetry, primarily due to organ overlap. The highest difference in absorbed dose between the imaging scenarios was observed in the spleen with a variation of up to 51.6%, while the difference for other target organs and tumors was less than 40%.</p><h3>Conclusion</h3><p>The dosimetry calculation derived from the 2D planar-based method consistently demonstrates a significantly higher absorbed dose in organs and tumors compared with the hybrid-based method. However, the hybrid method outperforms the planar method in terms of tumor visualization and overlap-free organ delineation.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"38 11","pages":"884 - 893"},"PeriodicalIF":2.5,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632485","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":"Impact of recent COVID-19 infection on perfusion and functional parameters derived from gated myocardial perfusion imaging in patients undergoing evaluation for coronary artery disease: correspondence","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1007/s12149-024-01961-1","DOIUrl":"10.1007/s12149-024-01961-1","url":null,"abstract":"","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"38 10","pages":"852 - 852"},"PeriodicalIF":2.5,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141615797","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}
Ayça Arçay Öztürk, Metin Erkılıç, Gonca Gül Bural, Funda Aydın, Adil Boz
{"title":"Physiological biodistribution on Ga68-PSMA PET/CT and the factors effecting biodistribution","authors":"Ayça Arçay Öztürk, Metin Erkılıç, Gonca Gül Bural, Funda Aydın, Adil Boz","doi":"10.1007/s12149-024-01957-x","DOIUrl":"10.1007/s12149-024-01957-x","url":null,"abstract":"<div><h3>Aim</h3><p>The study aims to determine the physiological and pathophysiological distribution of the radiopharmaceutical (Ga<sup>68</sup>-PSMA-617) and investigate whether there are differences in distribution according to the laboratory, histopathological and clinical findings that can affect image evaluation. Also, we aimed to determine cut-off values to distinguish physiological and pathological uptake in prostate, bone, and lymph nodes.</p><h3>Materials and Methods</h3><p>229 prostate cancer patients who underwent Ga<sup>68</sup>-PSMA PET/CT at our department were retrospectively analyzed. The patients were grouped according to PET/CT results, Gleason scores, PSA values, received treatments, metastatic status and other laboratory values. The SUV values of the organs, tissues, and pathological lesions of the patients in these subgroups were compared among themselves.</p><h3>Results</h3><p>No significant difference was detected in the physiological uptake of lymph nodes and bone between the groups. In the group with patients that received androgen deprivation therapy (ADT), the bone metastasis SUV values were found to be higher and the SUV values of the submandibular gland and renal cortex were found to be lower (Mann–Whitney <i>U</i>, <i>p</i> = 0.043; 0.004; 0.01, respectively). In the group with patients who received radiotherapy, the normal prostate tissue SUV values were determined to be higher (Mann–Whitney <i>U</i>, <i>p</i> = 0.009). The SUV values of the submandibular gland, muscle, liver, and blood pool were found to be lower in the group of patients with high serum LDH values. The cut-off SUVmax value was determined to be 6.945 (sensitivity 89.6%, specificity 98.1%) for primary prostate lesion; 4.72 for lymph node metastasis; 4.25 for bone metastasis. The serum PSA cut-off value to distinguish the negative/positive groups was found to be 1,505 (sensitivity 79.7%, specificity 77.3%).</p><h3>Conclusion</h3><p>In conclusion, PSMA-617 demonstrates a similar biodistribution with other PSMA ligands. The physiological uptake of lymph nodes and bone which are mostly metastasized in prostate cancer, are not affected by the factors we examined. It should be kept in mind that the normal prostate tissue uptake may increase in patients receiving radiotherapy, and the physiological/pathological uptake of the organs may differ due to the changes in PSMA expression in patients receiving ADT, tumor burden, and kidney function may affect the biodistribution.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"38 11","pages":"894 - 903"},"PeriodicalIF":2.5,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s12149-024-01957-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141557894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yoichi Shimizu, Masato Ando, Hiroyuki Watanabe, Masahiro Ono
{"title":"Novel technetium-99m-labeled bivalent PSMA-targeting probe based on hydroxamamide chelate for diagnosis of prostate cancer","authors":"Yoichi Shimizu, Masato Ando, Hiroyuki Watanabe, Masahiro Ono","doi":"10.1007/s12149-024-01959-9","DOIUrl":"10.1007/s12149-024-01959-9","url":null,"abstract":"<div><h3>Objective</h3><p>Prostate-specific membrane antigen (PSMA) is a well-known biomarker of prostate cancer. Previously, our group reported that the succinimidyl–cystatin–urea–glutamate (SCUE) moiety has a high affinity for PSMA. In this study, we developed the novel technetium-99m-labeled PSMA-targeting probe “[<sup>99m</sup>Tc]Tc-(Ham-SCUE)<sub>2</sub>” based on a hydroxamamide chelate with a bivalent SCUE and evaluated its potential as a SPECT imaging probe for the diagnosis of PSMA-expressing prostate cancer.</p><h3>Methods</h3><p>Ham-SCUE was synthesized by a one-step reaction with Ham-Mal and cysteine-urea-glutamine. Then, Ham-SCUE was reacted with [<sup>99m</sup>Tc]NaTcO<sub>4</sub> for 10 min at room temperature to obtain [<sup>99m</sup>Tc]Tc-(Ham-SCUE)<sub>2</sub>. [<sup>99m</sup>Tc]Tc-(Ham-SCUE)<sub>2</sub> was added to LNCaP (high PSMA expression) cells or PC3 (low PSMA expression) cells, and their radioactivity was measured 60 min after administration. The blocking study was performed by co-incubation of LNCaP cells with various concentrations of 2-PMPA (a PSMA inhibitor) for 15 min before adding [<sup>99m</sup>Tc]Tc-(Ham-SCUE)<sub>2</sub>. The biodistribution of [<sup>99m</sup>Tc]Tc-(Ham-SCUE)<sub>2</sub> in LNCaP/PC3 dual xenografted C.B.-17/Icr scid/scid Jcl mice was evaluated for 120 min after intravenous injection. The blocking study was performed by pretreatment of mice with 2-PMPA (10 mg/kg weight).</p><h3>Results</h3><p>[<sup>99m</sup>Tc]Tc-(Ham-SCUE)<sub>2</sub> was acquired at radiochemical yields of 56% with a radiochemical purity of over 95%. The cellular uptake level of [<sup>99m</sup>Tc]Tc-(Ham-SCUE)<sub>2</sub> by LNCaP cells was significantly higher than that by PC3 cells (LNCaP: 11.12 ± 0.71 vs. PC3: 1.40 ± 0.13%uptake/mg protein, <i>p</i> < 0.01), and the uptake was significantly suppressed by pretreatment with 2-PMPA (2.56 ± 0.37%uptake/mg protein, <i>p</i> < 0.05). IC<sub>50</sub> of 2-PMPA was 245 ± 47 nM. In the in vivo study, the radioactivity of LNCaP tumor tissue was significantly higher than that of PC3 tumor tissue at 120 min after the administration of [<sup>99m</sup>Tc]Tc-(Ham-SCUE)<sub>2</sub> (LNCaP: 9.97 ± 2.79, PC3: 1.16 ± 0.23%ID/g, <i>p</i> < 0.01), and was suppressed by pretreatment with 2-PMPA (2.50 ± 0.45%ID/g, <i>p</i> < 0.01).</p><h3>Conclusion</h3><p>[<sup>99m</sup>Tc]Tc-(Ham-SCUE)<sub>2</sub> has the potential to be a SPECT imaging agent for diagnosing high PSMA-expressing prostate cancer.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"38 10","pages":"847 - 851"},"PeriodicalIF":2.5,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554095","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":"New objective simple evaluation methods of amyloid PET/CT using whole-brain histogram and Top20%-Map","authors":"Chio Okuyama, Tatsuya Higashi, Koichi Ishizu, Naoya Oishi, Kuninori Kusano, Miki Ito, Shinya Kagawa, Tomoko Okina, Norio Suzuki, Hiroshi Hasegawa, Yasuhiro Nagahama, Hiroyuki Watanabe, Masahiro Ono, Hiroshi Yamauchi","doi":"10.1007/s12149-024-01956-y","DOIUrl":"10.1007/s12149-024-01956-y","url":null,"abstract":"<div><h3>Objective</h3><p>This study aims to assess the utility of newly developed objective methods for the evaluation of intracranial abnormal amyloid deposition using PET/CT histogram without use of cortical ROI analyses.</p><h3>Methods</h3><p>Twenty-five healthy volunteers (HV) and 38 patients with diagnosed or suspected dementia who had undergone <sup>18</sup>F-FPYBF-2 PET/CT were retrospectively included in this study. Out of them, <sup>11</sup>C-PiB PET/CT had been also performed in 13 subjects. In addition to the conventional methods, namely visual judgment and quantitative analyses using composed standardized uptake value ratio (comSUVR), the PET images were also evaluated by the following new parameters: the skewness and the mode-to-mean ratio (MMR) obtained from the histogram of the brain parenchyma; Top20%-map highlights the areas with high tracer accumulation occupying 20% volume of the total brain parenchymal on the individual’s CT images. We evaluated the utility of the new methods using histogram compared with the visual assessment and comSUVR. The results of these new methods between <sup>18</sup>F-FPYBF-2 and <sup>11</sup>C-PiB were also compared in 13 subjects.</p><h3>Results</h3><p>In visual analysis, 32, 9, and 22 subjects showed negative, border, and positive results, and composed SUVR in each group were 1.11 ± 0.06, 1.20 ± 0.13, and 1.48 ± 0.18 (<i>p</i> < 0.0001), respectively. Visually positive subjects showed significantly low skewness and high MMR (<i>p</i> < 0.0001), and the Top20%-Map showed the presence or absence of abnormal deposits clearly. In comparison between the two tracers, visual evaluation was all consistent, and the ComSUVR, the skewness, the MMR showed significant good correlation. The Top20%-Maps showed similar pattern.</p><h3>Conclusions</h3><p>Our new methods using the histogram of the brain parenchymal accumulation are simple and suitable for clinical practice of amyloid PET, and Top20%-Map on the individual’s brain CT can be of great help for the visual assessment.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"38 9","pages":"763 - 773"},"PeriodicalIF":2.5,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11339116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141440025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Differential centiloid scale normalization techniques: comparison between hybrid PET/MRI and independently acquired MRI","authors":"Ryo Yamakuni, Takenobu Murakami, Naoyuki Ukon, Takeyasu Kakamu, Wataru Toda, Kasumi Hattori, Hirofumi Sekino, Shiro Ishii, Kenji Fukushima, Hiroshi Matsuda, Yoshikazu Ugawa, Noritaka Wakasugi, Mitsunari Abe, Hiroshi Ito","doi":"10.1007/s12149-024-01955-z","DOIUrl":"10.1007/s12149-024-01955-z","url":null,"abstract":"<div><h3>Objective</h3><p>Centiloid (CL) scales play an important role in semiquantitative analyses of amyloid-β (Aβ) PET. CLs are derived from the standardized uptake value ratio (SUVR), which needs Aβ positron emission tomography (PET) normalization processing. There are two methods to collect the T1-weighted imaging (T1WI) for normalization: (i) anatomical standardization using simultaneously acquired T1WI (PET/MRI), usually adapted to PET images from PET/MRI scanners, and (ii) T1WI from a separate examination (PET + MRI), usually adapted to PET images from PET/CT scanners. This study aimed to elucidate the correlations and differences in CLs between when using the above two T1WI collection methods.</p><h3>Methods</h3><p>Among patients who underwent Aβ PET/MRI (using <sup>11</sup>C-Pittuberg compound B (<sup>11</sup>C-PiB) or <sup>18</sup>F‐flutemetamol (<sup>18</sup>F-FMM)) at our institution from 2015 to 2023, we selected 49 patients who also underwent other additional MRI examinations, including T1WI for anatomic standardization within 3 years. Thirty-one of them underwent <sup>11</sup>C‐PiB PET/MRI, and 18 participants underwent <sup>18</sup>F‐FMM PET/MRI. Twenty-five of them, additional MRI acquisition parameters were identical to simultaneous MRI during PET, and 24 participants were different. After normalization using PET/MRI or PET + MRI method each, SUVR was measured using the Global Alzheimer’s Association Initiative Network cerebral cortical and striatum Volume of Interest templates (VOI) and whole cerebellum VOI. Subsequently, CLs were calculated using the previously established equations for each Aβ PET tracer.</p><h3>Results</h3><p>Between PET/MRI and PET + MRI methods, CLs correlated linearly in <sup>11</sup>C-PiB PET (<i>y</i> = 1.00<i>x</i> – 0.11, <i>R</i><sup>2</sup> = 0.999), <sup>18</sup>F-FMM PET (<i>y</i> = 0.97<i>x</i> – 0.12, 0.997), identical additional MRI acquisition (<i>y</i> = 1.00<i>x</i> + 0.33, 0.999), different acquisition (<i>y</i> = 0.98<i>x</i> – 0.43, 0.997), and entire study group (<i>y</i> = 1.00<i>x</i> – 0.24, 0.999). Wilcoxon signed-rank test revealed no significant differences: <sup>11</sup>C-PiB (<i>p</i> = 0.49), <sup>18</sup>F-FMM (0.08), and whole PET (0.46). However, significant differences were identified in identical acquisition (<i>p</i> = 0.04) and different acquisition (<i>p</i> = 0.02). Bland–Altman analysis documented only a small bias between PET/MRI and PET + MRI in <sup>11</sup>C‐PiB PET, <sup>18</sup>F‐FMM PET, identical additional MRI acquisition, different acquisition, and whole PET (– 0.05, 0.67, – 0.30, 0.78, and 0.21, respectively).</p><h3>Conclusions</h3><p>Anatomical standardizations using PET/MRI and using PET + MRI can lead to almost equivalent CL. The CL values obtained using PET/MRI or PET + MRI normalization methods are consistent and comparable in clinical studies.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"38 10","pages":"835 - 846"},"PeriodicalIF":2.5,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431217","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":"Correction to: Annals of Nuclear Medicine","authors":"","doi":"10.1007/s12149-024-01953-1","DOIUrl":"10.1007/s12149-024-01953-1","url":null,"abstract":"","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"38 7","pages":"586 - 586"},"PeriodicalIF":2.5,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141417491","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}
İhsan Kaplan, Halil Kömek, Canan Can, Nadiye Akdeniz, Yunus Güzel, Ferat Kepenek, Ayhan Şenol, Serdar İleri, Hüseyin Karaoğlan, İhsan Solmaz, Mehmet Serdar Yıldırım, Veysi Şenses, Fulya Kaya, Cihan Gündoğan
{"title":"Should new organ involvement be included in Response Evaluation Criteria in PSMA Imaging?","authors":"İhsan Kaplan, Halil Kömek, Canan Can, Nadiye Akdeniz, Yunus Güzel, Ferat Kepenek, Ayhan Şenol, Serdar İleri, Hüseyin Karaoğlan, İhsan Solmaz, Mehmet Serdar Yıldırım, Veysi Şenses, Fulya Kaya, Cihan Gündoğan","doi":"10.1007/s12149-024-01954-0","DOIUrl":"10.1007/s12149-024-01954-0","url":null,"abstract":"<div><h3>Purpose</h3><p>The current study is intended to investigate the effect of new organ involvement on overall survival (OS) and modify the Response Evaluation Criteria in PSMA Imaging (RECIP) by including new organ involvement to RECIP 1.0.</p><h3>Materials and methods</h3><p>This retrospective study includes 114 patients diagnosed with metastatic castration-resistant prostate cancer (mCRPC) between September 2017 and June 2022 who had received docetaxel treatment and had baseline and post-treatment prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) images. The inclusion criteria were patients with pre- and post-treatment [<sup>18</sup>F]FDG PET/CT images and whose [<sup>18</sup>F]FDG PET images were negative. Those whose data were unavailable, who had additional malignancy, or who received abiraterone, enzalutamide, or Lutetium (Lu)-177 treatment were excluded. Age, Gleason score (GS), TPSA (total prostate-specific antigen) levels, surgical history, and OS information were recorded for each patient.</p><h3>Results</h3><p>The 114 patients herein had a median age of 72.5 (51–91) years and a median GS of 8 (7–10). New lesions were observed in 59 patients (51.7%) and new organ PSMA uptake was observed in 14 patients (12.2%). In the multivariate Cox regression analysis, volume-based treatment response (vTR)-total lesion PSMA (TLP), RECIP PSMA-VOL, modified RECIP (mRECIP) PSMA-VOL, and mRECIP TLP were independent prognostic factors for mortality (<i>p</i> < 0.001, <i>p</i> = 0.006, <i>p</i> = 0.003, and <i>p</i> = 0.003, respectively). The median OS of patients with new organ involvement and new lesion with PSMA uptake was 9.3 months (95% CI 2.1–16.5 months) and 11.8 months (95% CI 7.4–16.2 months), respectively.</p><h3>Conclusion</h3><p>The study concluded that new organ involvement had a shorter OS than new lesion involvement. In the mRECIP that we developed, unlike RECIP, we demonstrated that both PSMA-VOL and TLP value were independent prognostic factors for mortality.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"38 10","pages":"825 - 834"},"PeriodicalIF":2.5,"publicationDate":"2024-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141330245","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":"Inverse correlation between age of onset and myocardial amyloid deposition quantified by 99mTc-PYP scintigraphy in patients with wild-type transthyretin amyloid cardiomyopathy","authors":"Hiroshi Kanaya, Shinya Shiraishi, Kouji Ogasawara, Koya Iwashita, Fumi Sakamoto, Seiji Takashio, Yoshiki Mikami, Kenichi Tsujita, Toshinori Hirai","doi":"10.1007/s12149-024-01943-3","DOIUrl":"10.1007/s12149-024-01943-3","url":null,"abstract":"<div><h3>Objective</h3><p>Wild-type transthyretin amyloidosis cardiomyopathy (ATTRwt-CM) is increasingly recognized as a contributing factor to cardiac insufficiency in the elderly population. We aimed to identify the factors affecting age of onset of ATTRwt-CM, encompassing the assessment of amyloid deposition in myocardial tissue through the use of <sup>99m</sup>Tc-pyrophosphate (PYP) and clinical parameters.</p><h3>Methods</h3><p>A retrospective investigation involving a consecutive cohort of 107 cases, each having been diagnosed with ATTRwt-CM confirmed through histopathological and genetic analysis, was performed. All patients underwent PYP scintigraphy, and the heart-to-contralateral (H/CL) ratio was calculated to measure amyloid deposition in the myocardium. Univariate and multivariate analyses were performed to identify independent predictors of the age of onset of ATTRwt-CM, considering the H/CL ratio and various clinical risk factors for heart failure.</p><h3>Results</h3><p>Gender (<i>p = </i>0.03), Creatinine (Cr) (<i>r = </i>0.32, p < 0.01), hemoglobin (Hb) (<i>r = </i> − 0.44, <i>p < </i>0.01), albumin (Alb) (<i>r = </i> − 0.32, <i>p < </i>0.01), brain natriuretic peptide (BNP) (<i>r = </i>0.21, <i>p = </i>0.03), low-density lipoprotein-cholesterol (LDL-C) (<i>r = </i> − 0.27, <i>p < </i>0.01), and H/CL ratio (<i>r = </i> − 0.44, <i>p < </i>0.01) were all significantly associated with the onset age. In multiple regression analysis, the independent predictive factors for the onset age of ATTRwt-CM were identified as the H/CL ratio (<i>p < </i>0.01), Hb (<i>p < </i>0.01), and Cr (<i>p < </i>0.01).</p><h3>Conclusion</h3><p>The H/CL ratio, Hb, and Cr independently affect age of onset in patients with ATTRwt-CM. The H/CL ratio is inversely correlated with age of onset, and may be the sole factor in the development of heart failure in early onset patients, while it may have a synergistic effect on heart failure with anemia and renal dysfunction in late-onset patients.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"38 9","pages":"744 - 753"},"PeriodicalIF":2.5,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141316599","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}