心律失常性右室心肌病患者心脏 123iodo-metaiodobenzylguanidine SPECT/CT 定量评估：疾病监测的新视角。

IF 3 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Nuclear Cardiology Pub Date : 2024-09-01 DOI:10.1016/j.nuclcard.2024.101911

Johannes M. Hagen , Mathias J. Zacherl MD , Matthias Brendel MD , Sebastian Clauß MD , Stefan Kääb MD , Peter Bartenstein MD , Andrei Todica MD , Guido Böning PhD , Maximilian Fischer MD

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引用次数: 0

摘要

目的：123碘-甲碘苄基胍（123I-MIBG）的心胸比（H/M-Ratio）是评估心律失常性右室心肌病（ARVC）患者交感神经功能障碍的最新方法。本研究旨在评估 123I-MIBG 摄取的定量重建，并证明其与超声心动图参数的相关性：方法：使用 123I-MIBG 单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）定量成像，对 23 名确诊为 ARVC 或边缘 ARVC 的患者和 12 名患有其他心脏疾病并伴有心律失常的患者的心脏神经支配进行评估。根据定量图像重建后的 CT 扫描评估左心室（LV）和右心室（RV）的示踪剂摄取量。研究了示踪剂摄取量与超声心动图参数数据之间的关系：结果：123I-MIBG 在左心室和右心室摄取量的绝对定量是可行的，并与金标准 H/M-Ratio 精确相关。在比较灵敏度和特异性时，曲线下面积（AUC）更倾向于用 RV 标准化摄取值（SUV）而非右心室与纵隔比值（RV/M-Ratio）来诊断 ARVC。确诊的 ARVC 患者的 RV SUV 值降低与 RV 功能减退有关。RV极坐标图显示123I-MIBG摄取量全面降低，但RV无节段特异性降低：结论：ARCV 患者的 123I-MIBG SPECT 定量分析为临床报告提供了强大的潜力，并显示出与 RV 功能的显著相关性。RV 节段分析需要在更大样本中进行评估。总之，使用 SUV 进行心脏 123I-MIBG 成像有助于对确诊为 ARVC 的患者进行图像引导治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Quantitative assessment of cardiac 123iodo-metaiodobenzylguanidine SPECT/CT in patients with arrhythmogenic right ventricular cardiomyopathy: Novel insight in disease monitoring

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Quantitative assessment of cardiac 123iodo-metaiodobenzylguanidine SPECT/CT in patients with arrhythmogenic right ventricular cardiomyopathy: Novel insight in disease monitoring

Background

The heart-to-mediastinum ratio (H/M-Ratio) of ¹²³iodo-metaiodobenzylguanidine (¹²³I-MIBG) represents state-of-the-art assessment for sympathetic dysfunction in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). This study aims to evaluate quantitative reconstruction of ¹²³I-MIBG uptake and to demonstrate its correlation with echocardiographic parameters.

Methods

Cardiac innervation was assessed in 23 patients diagnosed with definite ARVC or borderline ARVC and 12 patients with other cardiac disease presenting arrhythmia, using quantitative ¹²³I-MIBG Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) imaging. Tracer uptake was evaluated in the left (LV) and right ventricle (RV) based on a CT scan after quantitative image reconstruction. The relationship between tracer uptake and echocardiographic parameter data was examined.

Results

Absolute quantification of ¹²³I-MIBG uptake in the LV and RV is feasible and correlates accurately with the gold standard H/M Ratio. When comparing sensitivity and specificity, the area under the curve (AUC) favors standardized uptake value (SUV) of the RV over the right-ventricle-to-mediastinum-ratio (RV/M-Ratio) for diagnosing ARVC. A reduced RV-SUV in patients with definite ARVC is associated with reduced RV function. RV polar maps revealed globally reduced ¹²³I-MIBG uptake without segment-specific reduction in the RV.

Conclusions

Quantitative ¹²³I-MIBG SPECT in ARCV patients offers robust potential for clinical reporting and demonstrates a significant correlation with RV function. Segmental RV analysis needs to be evaluated in larger samples. In summary, cardiac ¹²³I-MIBG imaging using SUV could facilitate image-guided therapy in patients diagnosed with ARVC.

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来源期刊

Journal of Nuclear Cardiology 医学-核医学

CiteScore

5.30

自引率

20.80%

发文量

249

审稿时长

4-8 weeks

期刊介绍： Journal of Nuclear Cardiology is the only journal in the world devoted to this dynamic and growing subspecialty. Physicians and technologists value the Journal not only for its peer-reviewed articles, but also for its timely discussions about the current and future role of nuclear cardiology. Original articles address all aspects of nuclear cardiology, including interpretation, diagnosis, imaging equipment, and use of radiopharmaceuticals. As the official publication of the American Society of Nuclear Cardiology, the Journal also brings readers the latest information emerging from the Society''s task forces and publishes guidelines and position papers as they are adopted.