[123I]-MIBG SPECT/CT对野生型转甲状腺蛋白淀粉样变性心肌病心脏交感神经绝对定量及左心室分割的可行性：I-NERVE研究。

IF 3 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Nuclear Cardiology Pub Date : 2025-03-01 DOI:10.1016/j.nuclcard.2025.102146

Alwin Tubben MD , Niek H.J. Prakken MD, PhD , Oleksandra V. Ivashchenko PhD , Hendrea S.A. Tingen MD , Andor W.J.M. Glaudemans MD, PhD , Walter Noordzij MD, PhD , Hans L.A. Nienhuis MD, PhD , Peter van der Meer MD, PhD , Riemer H.J.A. Slart MD, PhD

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引用次数: 0

摘要

目的：心脏交感神经元功能障碍是野生型转甲状腺蛋白淀粉样变性心肌病（attrt - cm）的早期标志。[123I]-MIBG成像评估心脏交感神经支配，但目前的方法缺乏体积活动量化。本研究旨在使用[123I]-MIBG SPECT/CT量化ATTRwt-CM的心脏交感神经元功能障碍，并将结果与超声心动图和心脏磁共振成像（CMR）的心脏功能和结构参数相关联。方法：我们进行了一项单中心、描述性、横断面研究，使用[123I]-MIBG SPECT/CT量化ATTRwt-CM的绝对心肌交感功能。回顾性重建允许左心室整体和分段的绝对示踪剂摄取量化，以kBq/mL， SUV和注射剂量的百分比（%ID）为单位。根据临床标准进行超声心动图、CMR和骨显像检查。分割[123I]-MIBG SPECT/CT值与超声心动图上的整体纵向应变（GLSS）、原生t1和CMR上的细胞外体积（ECV）相关。结果：前瞻性纳入29例attrt - cm患者（75.8±6.6岁，90%为男性）。所有患者均表现出心脏交感神经元功能障碍，中位晚期心脏与纵隔比值为1.69[1.45-1.89]，洗脱率为22.7%（16.4-27.3%）。SUVmean、SUVpeak、SUVmax和%ID分别为1.80±0.78、3.84±1.41、4.46±1.68和0.46±0.18，与半定量[123I]-MIBG测量结果相关。超声心动图上GLSS或CMR上原生T1和ECV均无相关性。结论：本研究证明了[123I]-MIBG SPECT/CT在attrt - cm中进行体积定量的可行性。SUVmean, SUVpeak， SUVmax和%ID与半定量测量相关，但与超声心动图或CMR的关键心脏参数无关。这证实了[123I]-MIBG SPECT/CT对心功能或病理不同方面的敏感性。试验注册：edract ref. 2020-003350-72，回顾性注册于2023年3月20日。https://classic.Clinicaltrials gov / ct2 /显示/ NCT05776212。

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Feasibility of the absolute quantification and left ventricular segmentation of cardiac sympathetic innervation in wild-type transthyretin amyloidosis cardiomyopathy with [123I]-MIBG SPECT/CT: The I-NERVE study

Background

Cardiac sympathetic neuronal dysfunction is an early marker in wild-type transthyretin amyloidosis cardiomyopathy (ATTRwt-CM). Iodine-123-labeled norepinephrine analog meta-iodobenzylguanidine ([¹²³I]-MIBG) imaging evaluates cardiac sympathetic innervation but lacks volumetric activity quantification in current methods. This study aims to quantify cardiac sympathetic neuronal dysfunction in ATTRwt-CM using [¹²³I]-MIBG single-photon emission computed tomography/ computed tomography (SPECT/CT) and correlate findings with functional and structural cardiac parameters from echocardiogram and cardiac magnetic resonance imaging (CMR).

Methods

We conducted a single-center, descriptive, cross-sectional study to quantify absolute myocardial sympathetic function in ATTRwt-CM using [¹²³I]-MIBG SPECT/CT. Retrospective reconstruction allowed for absolute tracer-uptake quantification of the left ventricle, overall and segmented, in kBq/mL, standard uptake value (SUV), and percentage of the injected dose (%ID). Echocardiography, CMR, and bone scintigraphy were performed according to clinical standards. Segmented [¹²³I]-MIBG SPECT/CT values were correlated with global longitudinal systolic strain (GLSS) on echocardiography, native-T1, and extracellular volume (ECV) on CMR using SPECT/CT fused with CMR.

Results

Twenty-nine ATTRwt-CM patients (75.8 ± 6.6 years, 90% male) were prospectively included. All exhibited cardiac sympathetic neuronal dysfunction, with a median late heart-to-mediastinum ratio of 1.69 (1.45–1.89) and a washout rate of 22.7% (16.4%–27.3%). SUV_mean, SUV_peak, SUV_max, and %ID were 1.80 ± .78, 3.84 ± 1.41, 4.46 ± 1.68, and .46 ± .18, respectively, correlating with semiquantitative [¹²³I]-MIBG measures. No correlations were found with GLSS on echocardiography or native T1 and ECV on CMR.

Conclusions

The current study demonstrates the feasibility of volumetric quantification of [¹²³I]–MIBG SPECT/CT in ATTRwt-CM. SUV_mean, SUV_peak, SUV_max, and %ID correlate with semi-quantitative measures but not with key cardiac parameters on echocardiography or CMR. This confirms the sensitivity of [¹²³I]-MIBG SPECT/CT to different aspects of cardiac function or pathology.

Trial registration

EudraCT ref. 2020-003350-72, retrospectively registered March 20, 2023. https://classic.clinicaltrials.gov/ct2/show/NCT05776212.

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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.