Annals of Nuclear Medicine最新文献

{"title":"Diagnostic performance of a deep-learning model using 18F-FDG PET/CT for evaluating recurrence after radiation therapy in patients with lung cancer","authors":"Changhwan Sung,&nbsp;Jungsu S. Oh,&nbsp;Byung Soo Park,&nbsp;Su Ssan Kim,&nbsp;Si Yeol Song,&nbsp;Jong Jin Lee","doi":"10.1007/s12149-024-01925-5","DOIUrl":"10.1007/s12149-024-01925-5","url":null,"abstract":"<div><h3>Objective</h3><p>We developed a deep learning model for distinguishing radiation therapy (RT)-related changes and tumour recurrence in patients with lung cancer who underwent RT, and evaluated its performance.</p><h3>Methods</h3><p>We retrospectively recruited 308 patients with lung cancer with RT-related changes observed on ¹⁸F-fluorodeoxyglucose positron emission tomography–computed tomography (¹⁸F-FDG PET/CT) performed after RT. Patients were labelled as positive or negative for tumour recurrence through histologic diagnosis or clinical follow-up after ¹⁸F-FDG PET/CT. A two-dimensional (2D) slice-based convolutional neural network (CNN) model was created with a total of 3329 slices as input, and performance was evaluated with five independent test sets.</p><h3>Results</h3><p>For the five independent test sets, the area under the curve (AUC) of the receiver operating characteristic curve, sensitivity, and specificity were in the range of 0.98–0.99, 95–98%, and 87–95%, respectively. The region determined by the model was confirmed as an actual recurred tumour through the explainable artificial intelligence (AI) using gradient-weighted class activation mapping (Grad-CAM).</p><h3>Conclusion</h3><p>The 2D slice-based CNN model using ¹⁸F-FDG PET imaging was able to distinguish well between RT-related changes and tumour recurrence in patients with lung cancer.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140574535","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":"Parametric net influx rate imaging of 68Ga-DOTATATE in patients with neuroendocrine tumors: assessment of lesion detectability","authors":"Hongyan Yin,&nbsp;Guobing Liu,&nbsp;Wujian Mao,&nbsp;Jing Lv,&nbsp;Haojun Yu,&nbsp;Dengfeng Cheng,&nbsp;Liang Cai,&nbsp;Hongcheng Shi","doi":"10.1007/s12149-024-01922-8","DOIUrl":"10.1007/s12149-024-01922-8","url":null,"abstract":"<div><h3>Objectives</h3><p>There has been developed a clinical dynamic total-body ⁶⁸Ga-DOTATATE PET/CT imaging protocol that allows quantitative imaging of net influx rate (<i>K</i>_<i>i</i>). Using qualitative and quantitative analyses of clinical studies, this retrospective study aims to assess whether parametric <i>K</i>_<i>i</i> images improve lesion detectability.</p><h3>Methods</h3><p>Using a 194-cm axial field-of-view PET/CT scanner, 52 patients with neuroendocrine tumors underwent a 60-min dynamic total-body ⁶⁸Ga-DOTATATE scan. Parametric <i>K</i>_<i>i</i> images and static standardized uptake value (SUV) images were generated. In addition to visual inspection of both sets of images, a quantitative analysis of 249 individual lesions was conducted using the target-to-background (TBR) metric.</p><h3>Results</h3><p>There were 52 patients who underwent dynamic total-body ⁶⁸Ga-DOTATATE PET/CT scans. A total of 249 lesions were evaluated, of which 66 lesions were biopsy-proven and 183 lesions were unproven. <i>K</i>_<i>i</i> images produced two fewer false positives than the SUV images. Overall, our results from 66 proven NET lesions suggested similar sensitivity (98.5%) but improved accuracy (from 95.6 to 97.1%) and potentially enhanced specificity with<i> K</i>_<i>i</i> over SUV imaging. Besides, there was no difference in the number of pathological lesions identified visually in both images. However, <i>K</i>_<i>i</i> TBR was significantly higher than SUV TBR quantitatively (<i>P</i> &lt; 0.001).</p><h3>Conclusions</h3><p>Patlak <i>K</i>_<i>i</i> imaging provides nuclear physicians with a PET image with higher tumor contrast which may enhance confidence in diagnosis with possibly reduced false positive results, albeit an equivalent detectability, compared to static SUV image.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140590720","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 effect of harmonization on the variability of PET radiomic features extracted using various segmentation methods","authors":"Seyyed Ali Hosseini,&nbsp;Isaac Shiri,&nbsp;Pardis Ghaffarian,&nbsp;Ghasem Hajianfar,&nbsp;Atlas Haddadi Avval,&nbsp;Milad Seyfi,&nbsp;Stijn Servaes,&nbsp;Pedro Rosa-Neto,&nbsp;Habib Zaidi,&nbsp;Mohammad Reza Ay","doi":"10.1007/s12149-024-01923-7","DOIUrl":"10.1007/s12149-024-01923-7","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aimed to examine the robustness of positron emission tomography (PET) radiomic features extracted via different segmentation methods before and after ComBat harmonization in patients with non-small cell lung cancer (NSCLC).</p><h3>Methods</h3><p>We included 120 patients (positive recurrence = 46 and negative recurrence = 74) referred for PET scanning as a routine part of their care. All patients had a biopsy-proven NSCLC. Nine segmentation methods were applied to each image, including manual delineation, K-means (KM), watershed, fuzzy-C-mean, region-growing, local active contour (LAC), and iterative thresholding (IT) with 40, 45, and 50% thresholds. Diverse image discretizations, both without a filter and with different wavelet decompositions, were applied to PET images. Overall, 6741 radiomic features were extracted from each image (749 radiomic features from each segmented area). Non-parametric empirical Bayes (NPEB) ComBat harmonization was used to harmonize the features. Linear Support Vector Classifier (LinearSVC) with L1 regularization For feature selection and Support Vector Machine classifier (SVM) with fivefold nested cross-validation was performed using StratifiedKFold with ‘n_splits’ set to 5 to predict recurrence in NSCLC patients and assess the impact of ComBat harmonization on the outcome.</p><h3>Results</h3><p>From 749 extracted radiomic features, 206 (27%) and 389 (51%) features showed excellent reliability (ICC ≥ 0.90) against segmentation method variation before and after NPEB ComBat harmonization, respectively. Among all, 39 features demonstrated poor reliability, which declined to 10 after ComBat harmonization. The 64 fixed bin widths (without any filter) and wavelets (LLL)-based radiomic features set achieved the best performance in terms of robustness against diverse segmentation techniques before and after ComBat harmonization. The first-order and GLRLM and also first-order and NGTDM feature families showed the largest number of robust features before and after ComBat harmonization, respectively. In terms of predicting recurrence in NSCLC, our findings indicate that using ComBat harmonization can significantly enhance machine learning outcomes, particularly improving the accuracy of watershed segmentation, which initially had fewer reliable features than manual contouring. Following the application of ComBat harmonization, the majority of cases saw substantial increase in sensitivity and specificity.</p><h3>Conclusion</h3><p>Radiomic features are vulnerable to different segmentation methods. ComBat harmonization might be considered a solution to overcome the poor reliability of radiomic features.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s12149-024-01923-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140590337","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":"Examination of iatrogenic FDG accumulation after COVID-19 vaccination","authors":"Keiko Takahashi,&nbsp;Osamu Manabe,&nbsp;Kazuya Shizukuishi,&nbsp;Hirohumi Shibata,&nbsp;Hiroki Kawakami,&nbsp;Akira Otsuka,&nbsp;Noriko Oyama-Manabe","doi":"10.1007/s12149-024-01909-5","DOIUrl":"10.1007/s12149-024-01909-5","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aimed to investigate the frequency of COVID-19 vaccine-induced reactive change and potential factors including blood type correlated with increased FDG uptake on positron emission tomography (PET)/computed tomography (CT).</p><h3>Materials and methods</h3><p>We evaluated 284 patients who underwent PET/CT between June and September 2021 and had a known history of COVID-19 vaccination. Information on the injection site, vaccine type, and adverse reactions was obtained. We visually assessed the presence or absence of accumulation in the axillary and supraclavicular lymph nodes and the deltoid muscles. We measured the maximum standardized uptake value (SUVmax) using semi-quantitative analysis.</p><h3>Results</h3><p>Our study included 158 males and 126 females aged 16–94. The median time between vaccination and PET/CT was 9 and 42 days for patients who had received their first and second doses, respectively. We observed axillary lymph node accumulation, supraclavicular lymph node accumulation, and deltoid muscle accumulation in 98 (SUVmax 1.07–25.1), nine (SUVmax 2.28–14.5), and 33 cases (SUVmax 0.93–7.42), respectively. In cases with axillary lymph node (<i>P</i> = 0.0057) or deltoid muscle (<i>P</i> = 0.047) accumulation, the shorter the time since vaccination, the higher the FDG accumulation. Patients with axillary lymph node accumulation were significantly younger (<i>P</i> &lt; 0.0001) and had a significantly higher frequency of adverse reactions such as fever (<i>P</i> &lt; 0.0001) and myalgia (<i>P</i> = 0.002). No significant relationship was observed between blood type and the frequency of FDG accumulation. Logistic regression analysis also showed that age, gender, days since vaccination, and adverse reactions such as fever and myalgia were important factors for axillary lymph node accumulation.</p><h3>Conclusion</h3><p>Our study found that FDG accumulation in the axillary lymph nodes and deltoid muscle was higher within a shorter time after vaccination, and axillary lymph node accumulation was higher in young patients, females, and those with adverse reactions of fever and myalgia. No significant relationship was observed between blood type and the frequency of FDG accumulation. Confirming the vaccination status, time since vaccination, and the presence of adverse reactions before PET may reduce false positives.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334472","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":"Manual on the proper use of the 211At-labeled PSMA ligand ([211At]PSMA-5) for clinical trials of targeted alpha therapy (1st edition)","authors":"Tadashi Watabe,&nbsp;Masao Namba,&nbsp;Sachiko Yanagida,&nbsp;Yoshihide Nakamura,&nbsp;Takahiro Yamada,&nbsp;Saori Tatsuno,&nbsp;Aritoshi Ri,&nbsp;Shuhei Yoshida,&nbsp;Kumiko Uyama,&nbsp;Seigo Kinuya,&nbsp;Noriyuki Tomiyama,&nbsp;Makoto Hosono","doi":"10.1007/s12149-024-01916-6","DOIUrl":"10.1007/s12149-024-01916-6","url":null,"abstract":"<div><p>Recently, an astatine-labeled prostate-specific membrane antigen (PSMA) ligand ([²¹¹At]PSMA-5) has been developed for the targeted alpha therapy of patients with prostate cancer. This manual delineates its physicochemical characteristics to assist healthcare professionals in understanding the α-ray-emitting drug of [²¹¹At]PSMA-5 when administered to patients. The safety considerations regarding the handling and use of this drug in clinical trials are outlined, based on the proper usage manual of previous studies. The dose limits, as defined by the guidelines of the International Commission on Radiological Protection (ICRP) and the International Atomic Energy Agency (IAEA), are assessed for patients’ caregivers and the general public. According to the calculations provided in this manual, clinical trials involving [²¹¹At]PSMA-5 can be safely conducted for these populations even if patients are released after its administration. Moreover, this manual provides comprehensive guidance on the handling of [²¹¹At]PSMA-5 for healthcare facilities, and compiles a list of precautionary measures to be distributed among patients and their caregivers. While this manual was created by a research team supported by Ministry of Health, Labour, and Welfare in Japan and approved by Japanese Society of Nuclear Medicine, its applicability extends to healthcare providers in other countries. This manual aims to facilitate conducting clinical trials using [²¹¹At]PSMA-5 in patients with prostate cancer.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11016504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140317684","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":"18F-FDG PET/CT metabolism multi-parameter prediction of chemotherapy efficacy in locally progressive gastric cancer","authors":"Luqiang Jin,&nbsp;Linghe Zhang,&nbsp;Liping Fu,&nbsp;Fahuan Song,&nbsp;Aiping Cheng","doi":"10.1007/s12149-024-01921-9","DOIUrl":"10.1007/s12149-024-01921-9","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aimed to use an ¹⁸F-FDG PET/CT multiparametric quantitative analysis to determine the efficacy of neoadjuvant chemotherapy in patients with locally progressive gastric cancer.</p><h3>Materials and methods</h3><p>We conducted a retrospective analysis of 34 patients with pathologically identified gastric cancer who received neoadjuvant chemotherapy and surgery. Chemotherapy regimens were followed and ¹⁸F-FDG PET/CT was conducted. We ascertained multiparamaters of the target lesions pre- and post-treatment and determined the ideal cutoff values for the percentage change in biomarkers. Independent factors were evaluated using binary logistic regression. A response classification system was used to explore the association between metabolic and anatomical responses and the degree of pathological remission.</p><h3>Results</h3><p>Binary logistic regression analysis showed that Lauren bowel type and change in total lesion glycolysis &gt;45.2% were risk predictors for the efficacy of neoadjuvant chemotherapy; total lesion glycolysis demonstrated the best predictive efficacy. The categorical variable system of the two-module response (metabolic and anatomical response) group had a higher predictive accuracy than that of the single-module response (metabolic or anatomical response) group.</p><h3>Conclusions</h3><p>Using ¹⁸F-FDG PET/CT multiparametric quantitative analysis, Lauren bowel type and change in total lesion glycolysis &gt;45.2% were independent predictors of the efficacy of neoadjuvant chemotherapy in patients with gastric adenocarcinoma. Additionally, the dual-module assessment demonstrated high predictive efficacy.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11108936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140304489","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":"Evaluation of two-dimensional total bone uptake (2D-TBU) and bone scan index (BSI) extracted from active bone metastatic burden on the bone scintigraphy in patients with radium-223 treatment","authors":"Shohei Fukai,&nbsp;Hiromitsu Daisaki,&nbsp;Takuro Umeda,&nbsp;Naoki Shimada,&nbsp;Takashi Terauchi,&nbsp;Mitsuru Koizumi","doi":"10.1007/s12149-024-01918-4","DOIUrl":"10.1007/s12149-024-01918-4","url":null,"abstract":"<div><h3>Objective</h3><p>Radium-223 is a first alpha-emitting radionuclide treatment for metastatic castration-resistant prostate cancer (mCRPC) patients with bone metastases. Although the spread-based bone scan index (BSI) and novel index of the intensity-based two-dimensional total bone uptake (2D-TBU) from bone scintigraphy may provide useful input in radium-223 treatment, they have not been evaluated in detail yet. This study aimed to fill this gap by evaluating BSI and 2D-TBU in patients treated with radium-223.</p><h3>Methods</h3><p>Twenty-seven Japanese patients with mCRPC treated with radium-223 were retrospectively analyzed. The patients were evaluated via blood tests and bone scans at baseline and 3 cycles intervals of treatment. BSI and 2D-TBU were analyzed via VSBONE BSI in terms of correlations, response to radium-223 treatment, association with treatment completion, and the Kaplan–Meier survival analysis was performed.</p><h3>Results</h3><p>Nineteen patients (70.4%) completed six cycles of radium-223 treatment, whereas eight patients (29.6%) did not complete the treatment regimen. A significant difference in baseline BSI and 2D-TBU was observed between these groups of patients. Both BSI and 2D-TBU were highly correlated (r = 0.96, <i>p</i> &lt; 0.001). Univariate analysis showed an association between radium-223 completion in median BSI and 2D-TBU values (<i>p</i> = 0.015) and completion percentage differences (91.7% vs. 45.5%; <i>p</i> = 0.027). The Kaplan–Meier product limit estimator showed that the median overall survival was 25.2 months (95% CI 14.0–33.6 months) in the completion group and 7.5 months (95% CI 3.3–14.2 months) in the without completion group (<i>p</i> &lt; 0.001). The overall survival based on median cutoff levels showed a significant difference in 2D-TBU (<i>p</i> = 0.007), but not in BSI (<i>p</i> = 0.15).</p><h3>Conclusions</h3><p>The 2D-TBU may offer advantages over BSI in classifying patients towards radium-223 treatment based on the degree of progression of bone metastases. This study supports the importance of preliminary assessment of bone metastasis status using BSI and 2D-TBU extracted from VSBONE BSI for radium-223 treatment decisions.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140189402","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 consistency in centiloid scale among different analytical methods in amyloid PET: the CapAIBL, VIZCalc, and Amyquant methods","authors":"Cong Shang,&nbsp;Keita Sakurai,&nbsp;Takashi Nihashi,&nbsp;Yutaka Arahata,&nbsp;Akinori Takeda,&nbsp;Kazunari Ishii,&nbsp;Kenji Ishii,&nbsp;Hiroshi Matsuda,&nbsp;Kengo Ito,&nbsp;Takashi Kato,&nbsp;Hiroshi Toyama,&nbsp;Akinori Nakamura,&nbsp;BATON Study Group","doi":"10.1007/s12149-024-01919-3","DOIUrl":"10.1007/s12149-024-01919-3","url":null,"abstract":"<div><h3>Objective</h3><p>The Centiloid (CL) scale is a standardized measure for quantifying amyloid deposition in amyloid positron emission tomography (PET) imaging. We aimed to assess the agreement among 3 CL calculation methods: CapAIBL, VIZCalc, and Amyquant.</p><h3>Methods</h3><p>This study included 192 participants (mean age: 71.5 years, range: 50–87 years), comprising 55 with Alzheimer’s disease, 65 with mild cognitive impairment, 13 with non-Alzheimer's dementia, and 59 cognitively normal participants. All the participants were assessed using the three CL calculation methods. Spearman’s rank correlation, linear regression, Friedman tests, Wilcoxon signed-rank tests, and Bland–Altman analysis were employed to assess data correlations, linear associations, method differences, and systematic bias, respectively.</p><h3>Results</h3><p>Strong correlations (rho = 0.99, <i>p</i> &lt; .001) were observed among the CL values calculated using the three methods. Scatter plots and regression lines visually confirmed these strong correlations and met the validation criteria. Despite the robust correlations, a significant difference in CL value between CapAIBL and Amyquant was observed (36.1 ± 39.7 vs. 34.9 ± 39.4; <i>p</i> &lt; .001). In contrast, no significant differences were found between CapAIBL and VIZCalc or between VIZCalc and Amyquant. The Bland–Altman analysis showed no observable systematic bias between the methods.</p><h3>Conclusions</h3><p>The study demonstrated strong agreement among the three methods for calculating CL values. Despite minor variations in the absolute values of the Centiloid scores obtained using these methods, the overall agreement suggests that they are interchangeable.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11108942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140183509","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":"Novel indices representing heterogeneous distributions of myocardial perfusion imaging","authors":"Misato Chimura,&nbsp;Tomohito Ohtani,&nbsp;Fusako Sera,&nbsp;Rie Higuchi,&nbsp;Kenji Kajitani,&nbsp;Kenichi Nakajima,&nbsp;Yasushi Sakata","doi":"10.1007/s12149-024-01920-w","DOIUrl":"10.1007/s12149-024-01920-w","url":null,"abstract":"<div><h3>Introduction</h3><p>Heterogeneous distribution in myocardial perfusion images (MPI) obtained by scintigraphy is often observed in cardiac diseases with normal myocardial perfusion. However, quantitative assessments of such heterogeneity have not been established. We hypothesized that the heterogeneity in MPI can be quantitatively evaluated through histogram analysis, calculating the standard deviation (SD), the 95% bandwidth (BW95%), and entropy.</p><h3>Methods</h3><p>We examined resting ^99mTc-MIBI images in 20 healthy subjects and 29 patients with cardiac disease who had none or very-mild reduced myocardial perfusion evaluated as a low summed rest score (0 to 4, the range of the studied healthy subjects). Two nuclear medicine specialists blindly divided them into two groups: non-heterogeneity or heterogeneity group, based solely on their visual assessments of heterogeneity on splash and polar maps generated from single-photon emission computed tomography (SPECT) images. The %uptake was determined by dividing the tracer count of each pixel by the tracer count of the pixel with the highest value in the LV myocardium. SD, BW95%, and entropy from histogram patterns were analyzed from the polar map data array of each %uptake. We investigated whether heterogeneity could be assessed using SD, BW95, and entropy in two groups classified by visual assessments. Additionally, we evaluated the area under the curve (AUC) to identify heterogeneity in the receiver operating characteristic curve analysis.</p><h3>Results</h3><p>Based solely on visual assessments, 11 (22%) and 38 (78%) cases were classified into the non-heterogeneity and heterogeneity groups, respectively. The non-heterogeneity group consisted of only healthy subjects, and all patients with cardiac disease were classified into the heterogeneity group. The cases in the heterogeneity group had significantly higher values of heterogeneity indices (SD, BW95%, and entropy) in %uptake than those in the non-heterogeneity group (<i>p</i> &lt; 0.05 for all). The AUCs of the heterogeneity indices were sufficiently high (AUCs &gt; 0.90 for all) in distinguishing cases with visually heterogeneous distribution or patients with cardiac disease.</p><h3>Conclusions</h3><p>Heterogeneity in MPI can be evaluated using SD, BW95%, and entropy through histogram analysis. These novel indices may help identify patients with subtle myocardial changes, even in images that show preserved perfusion (345/350).</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s12149-024-01920-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140172905","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":"Prognostic value of left ventricular mechanical dyssynchrony indices derived from gated myocardial perfusion SPECT in coronary artery disease: a systematic review and meta-analysis","authors":"Koeun Lee,&nbsp;Sangwon Han,&nbsp;Jeongryul Ryu,&nbsp;Sang-Geon Cho,&nbsp;Dae Hyuk Moon","doi":"10.1007/s12149-024-01915-7","DOIUrl":"10.1007/s12149-024-01915-7","url":null,"abstract":"<div><h3>Purpose</h3><p>Left ventricular mechanical dyssynchrony (LVMD) is an important prognostic factor in coronary artery disease. A growing body of evidence indicates that LVMD parameters derived from phase analysis of gated myocardial SPECT may allow risk stratification for future cardiac events. We performed a systematic review and meta-analysis on the prognostic value of LVMD on gated SPECT in patients with coronary artery disease.</p><h3>Methods</h3><p>PubMed, Embase, and the Cochrane library were searched until August 25, 2022, for studies reporting the prognostic value of LVMD on gated SPECT for outcomes of all-cause death, cardiac death, or major adverse cardiovascular event (MACE) in patients with coronary artery disease. Hazard ratios (HRs) and their 95% confidence intervals (CIs) were meta-analytically pooled using a random-effects model.</p><h3>Results</h3><p>Nine studies (26,750 patients) were included in a qualitative synthesis. Among the SPECT LVMD parameters used in various studies, high phase standard deviation, phase bandwidth, and phase entropy were widely evaluated and reported to be associated with high rates of all-cause death, cardiac death, or MACE. For five studies (23,973 patients) in the quantitative synthesis, the pooled HR of LVMD for predicting MACE was 2.81 (95% CI 2.03–3.88). Studies using combined phase parameters to define LVMD showed higher HRs than a study using phase entropy (<i>p</i> = 0.0180).</p><h3>Conclusion</h3><p>LVMD from gated myocardial SPECT is a significant prognostic factor for coronary artery disease. Phase analysis of gated SPECT may be useful for accurate risk stratification and could be applied for clinical decision-making in such patients.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140152038","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}