Sophia Koukouraki, Nikolaos Kapsoritakis, Olga Bourogianni, Maria Stathaki, Ioannis Zaganas, Alexandros Patrianakos, Anthi Plevritaki, Dafni Korela, Maria Marketou, Emmanouil Foukarakis
{"title":"基于SPECT/CT SUV的指标：将疑似转甲状腺素心脏淀粉样变性患者划分为不同佩鲁吉尼分级的有前途的诊断工具？","authors":"Sophia Koukouraki, Nikolaos Kapsoritakis, Olga Bourogianni, Maria Stathaki, Ioannis Zaganas, Alexandros Patrianakos, Anthi Plevritaki, Dafni Korela, Maria Marketou, Emmanouil Foukarakis","doi":"10.1967/s002449912601","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to evaluate the contribution of single photon emission computed tomography/computed tomography (SPECT/CT) standardized uptake value (SUV) metrics in classifying patients with suspected transthyretin cardiac amyloidosis (ATTR-CA) among the different Perugini grades.</p><p><strong>Subjects and methods: </strong>One hundred four patients suspected of ATTR-CA underwent planar scintigraphy with bone seeking tracer (<sup>99m</sup>Tc pyrophosphate-PYP). Patients were classified according to the Perugini scale, the H/CL, H/Bone and H/Bkg ratios. A subset of 48 patients received additional SPECT/CT. Single photon emission computed tomography/CT SUV quantitative parameters, of the heart, myocardium, lungs, liver, soft tissues, bone, and SUV ratios (SUV<sub>max</sub>myo, SUV<sub>max</sub>lungs, SUV<sub>max</sub>liver, SUV<sub>max</sub>bone and SUV<sub>max</sub>soft tissue ratios), were evaluated in order to investigate potential metrics that could more clearly differentiate Perugini grades.</p><p><strong>Results: </strong>A total of 33.7% of patients were considered grade 0, 34.6% grade 1 and 31.7% grade 2/3. A combination of H/CL >1.33 and H/Bone >0.85 showed the highest sensitivity 100%. Standardized uptake value-based metrics clearly differentiated grade 0 or 1 vs grades 2 or 3, whereas no significant difference was found between grades 0 and 1, or between grades 1 and 2. The combined cut-off values H/CL 1.33 and SUV<sub>max</sub>myo 2.88 yielded 100% sensitivity and 84.6% specificity in differentiating ATTR-CA positives vs negatives. The metric SUV<sub>max</sub>myo/SUV<sub>max</sub>liver was the best metric to classify patients with grade 1 as negative (grade 0) or positive (grade 2 or 3).</p><p><strong>Conclusion: </strong>Single photon emission computed tomography/CT SUV metrics could be complementary to planar scintigraphy in classifying patients among the different Perugini grades. The ratio SUV<sub>max</sub>myo/SUV<sub>max</sub>liver was the only parameter with high affinity to differentiate patients with grade 1, as grade 0 or grade 2/3 for ATTR-CA.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":" ","pages":"172-180"},"PeriodicalIF":0.9000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"SPECT/CT SUV-based metrics: A promising diagnostic tool in classifying patients with suspected transthyretin cardiac amyloidosis among the different Perugini grades?\",\"authors\":\"Sophia Koukouraki, Nikolaos Kapsoritakis, Olga Bourogianni, Maria Stathaki, Ioannis Zaganas, Alexandros Patrianakos, Anthi Plevritaki, Dafni Korela, Maria Marketou, Emmanouil Foukarakis\",\"doi\":\"10.1967/s002449912601\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The purpose of this study was to evaluate the contribution of single photon emission computed tomography/computed tomography (SPECT/CT) standardized uptake value (SUV) metrics in classifying patients with suspected transthyretin cardiac amyloidosis (ATTR-CA) among the different Perugini grades.</p><p><strong>Subjects and methods: </strong>One hundred four patients suspected of ATTR-CA underwent planar scintigraphy with bone seeking tracer (<sup>99m</sup>Tc pyrophosphate-PYP). Patients were classified according to the Perugini scale, the H/CL, H/Bone and H/Bkg ratios. A subset of 48 patients received additional SPECT/CT. Single photon emission computed tomography/CT SUV quantitative parameters, of the heart, myocardium, lungs, liver, soft tissues, bone, and SUV ratios (SUV<sub>max</sub>myo, SUV<sub>max</sub>lungs, SUV<sub>max</sub>liver, SUV<sub>max</sub>bone and SUV<sub>max</sub>soft tissue ratios), were evaluated in order to investigate potential metrics that could more clearly differentiate Perugini grades.</p><p><strong>Results: </strong>A total of 33.7% of patients were considered grade 0, 34.6% grade 1 and 31.7% grade 2/3. A combination of H/CL >1.33 and H/Bone >0.85 showed the highest sensitivity 100%. Standardized uptake value-based metrics clearly differentiated grade 0 or 1 vs grades 2 or 3, whereas no significant difference was found between grades 0 and 1, or between grades 1 and 2. The combined cut-off values H/CL 1.33 and SUV<sub>max</sub>myo 2.88 yielded 100% sensitivity and 84.6% specificity in differentiating ATTR-CA positives vs negatives. The metric SUV<sub>max</sub>myo/SUV<sub>max</sub>liver was the best metric to classify patients with grade 1 as negative (grade 0) or positive (grade 2 or 3).</p><p><strong>Conclusion: </strong>Single photon emission computed tomography/CT SUV metrics could be complementary to planar scintigraphy in classifying patients among the different Perugini grades. The ratio SUV<sub>max</sub>myo/SUV<sub>max</sub>liver was the only parameter with high affinity to differentiate patients with grade 1, as grade 0 or grade 2/3 for ATTR-CA.</p>\",\"PeriodicalId\":12871,\"journal\":{\"name\":\"Hellenic journal of nuclear medicine\",\"volume\":\" \",\"pages\":\"172-180\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2023-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hellenic journal of nuclear medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1967/s002449912601\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/12/14 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hellenic journal of nuclear medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1967/s002449912601","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/12/14 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
SPECT/CT SUV-based metrics: A promising diagnostic tool in classifying patients with suspected transthyretin cardiac amyloidosis among the different Perugini grades?
Objective: The purpose of this study was to evaluate the contribution of single photon emission computed tomography/computed tomography (SPECT/CT) standardized uptake value (SUV) metrics in classifying patients with suspected transthyretin cardiac amyloidosis (ATTR-CA) among the different Perugini grades.
Subjects and methods: One hundred four patients suspected of ATTR-CA underwent planar scintigraphy with bone seeking tracer (99mTc pyrophosphate-PYP). Patients were classified according to the Perugini scale, the H/CL, H/Bone and H/Bkg ratios. A subset of 48 patients received additional SPECT/CT. Single photon emission computed tomography/CT SUV quantitative parameters, of the heart, myocardium, lungs, liver, soft tissues, bone, and SUV ratios (SUVmaxmyo, SUVmaxlungs, SUVmaxliver, SUVmaxbone and SUVmaxsoft tissue ratios), were evaluated in order to investigate potential metrics that could more clearly differentiate Perugini grades.
Results: A total of 33.7% of patients were considered grade 0, 34.6% grade 1 and 31.7% grade 2/3. A combination of H/CL >1.33 and H/Bone >0.85 showed the highest sensitivity 100%. Standardized uptake value-based metrics clearly differentiated grade 0 or 1 vs grades 2 or 3, whereas no significant difference was found between grades 0 and 1, or between grades 1 and 2. The combined cut-off values H/CL 1.33 and SUVmaxmyo 2.88 yielded 100% sensitivity and 84.6% specificity in differentiating ATTR-CA positives vs negatives. The metric SUVmaxmyo/SUVmaxliver was the best metric to classify patients with grade 1 as negative (grade 0) or positive (grade 2 or 3).
Conclusion: Single photon emission computed tomography/CT SUV metrics could be complementary to planar scintigraphy in classifying patients among the different Perugini grades. The ratio SUVmaxmyo/SUVmaxliver was the only parameter with high affinity to differentiate patients with grade 1, as grade 0 or grade 2/3 for ATTR-CA.
期刊介绍：
The Hellenic Journal of Nuclear Medicine published by the Hellenic Society of
Nuclear Medicine in Thessaloniki, aims to contribute to research, to education and
cover the scientific and professional interests of physicians, in the field of nuclear
medicine and in medicine in general. The journal may publish papers of nuclear
medicine and also papers that refer to related subjects as dosimetry, computer science,
targeting of gene expression, radioimmunoassay, radiation protection, biology, cell
trafficking, related historical brief reviews and other related subjects. Original papers
are preferred. The journal may after special agreement publish supplements covering
important subjects, dully reviewed and subscripted separately.
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