Quantitative SPECT/CT parameters of myocardial 99mTechnetium-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD) uptake in suspected cardiac transthyretin amyloidosis
Abstract Background 99mTc-labelled bisphosphonates are used for imaging assessment of patients with transthyretin cardiac amyloidosis (ATTR). Present study evaluates whether quantitative SPECT/CT measurement of absolute myocardial 99mTc-labelled 3,3-diphosphono-1,2-propanodicarboxylic acid (Tc-DPD)...
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doaj-fc45544c7d9840f79c5f6d73a1c02a2a2021-09-12T11:17:52ZengSpringerOpenEJNMMI Research2191-219X2021-09-0111111010.1186/s13550-021-00828-0Quantitative SPECT/CT parameters of myocardial 99mTechnetium-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD) uptake in suspected cardiac transthyretin amyloidosisSimona Ben-Haim0A. Chicheportiche1E. Goshen2M. Arad3M. Smekhov4L. J. Menezes5P. M. Elliott6E. O’Mahoney7E. Stern8Bella Yuzefovich9J. B. Bomanji10Hadassah Medical Center, Hebrew UniversityHadassah Medical Center, Hebrew UniversityWolfson Medical Center, Sackler School of Medicine, Tel Aviv UniversityChaim Sheba Medical CenterChaim Sheba Medical CenterNIHR Biomedical Research Centre, UCL Institute of Nuclear MedicineNIHR Biomedical Research Centre, UCL Institute of Nuclear MedicineNIHR Biomedical Research Centre, UCL Institute of Nuclear MedicineGE HealthcareGE HealthcareNIHR Biomedical Research Centre, UCL Institute of Nuclear MedicineAbstract Background 99mTc-labelled bisphosphonates are used for imaging assessment of patients with transthyretin cardiac amyloidosis (ATTR). Present study evaluates whether quantitative SPECT/CT measurement of absolute myocardial 99mTc-labelled 3,3-diphosphono-1,2-propanodicarboxylic acid (Tc-DPD) uptake can diagnose patients with suspected ATTR. Methods Twenty-eight patients (25 male, age 80.03 ± 6.99 years) with suspected ATTR referred for Tc-DPD imaging had planar and SPECT/CT imaging of the chest. Three operators independently obtained Tc-DPD myocardial SUVmax and SUVmean above threshold (SMaT) (20, 40 and 60% of SUVmax), using a semi-automated threshold segmentation method. Results were compared to visual grading (0–3) of cardiac uptake. Results Twenty-two patients (78%) had cardiac uptake (2 grade 1, 15 grade 2, 5 grade 3). SUVmax and SMaT segmentation thresholds enabled separating grades 2/3 from 0/1 with excellent inter- and intra-reader correlation. Cut-off values 6.0, 2.5, 3 and 4 for SUVmax, SMaT20,40,60, respectively, separated between grades 2/3 and 0 /1 with PPV and NPV of 100%. SMaT20,40,60(cardiac)/SUVmean (liver) and SMaT20,40,60(cardiac)/SUVmean(liver/lung) separated grades 2 and 3. Conclusion Quantitative SPECT/CT parameters of cardiac Tc-DPD uptake are robust, enabling separation of patients with grades 2 and 3 cardiac uptake from grades 0 and 1. Larger patient cohorts will determine the incremental value of SPECT/CT quantification for ATTR management.https://doi.org/10.1186/s13550-021-00828-0Amyloid heart diseaseSPECTImage analysisSPECT/CT quantitation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Simona Ben-Haim A. Chicheportiche E. Goshen M. Arad M. Smekhov L. J. Menezes P. M. Elliott E. O’Mahoney E. Stern Bella Yuzefovich J. B. Bomanji |
spellingShingle |
Simona Ben-Haim A. Chicheportiche E. Goshen M. Arad M. Smekhov L. J. Menezes P. M. Elliott E. O’Mahoney E. Stern Bella Yuzefovich J. B. Bomanji Quantitative SPECT/CT parameters of myocardial 99mTechnetium-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD) uptake in suspected cardiac transthyretin amyloidosis EJNMMI Research Amyloid heart disease SPECT Image analysis SPECT/CT quantitation |
author_facet |
Simona Ben-Haim A. Chicheportiche E. Goshen M. Arad M. Smekhov L. J. Menezes P. M. Elliott E. O’Mahoney E. Stern Bella Yuzefovich J. B. Bomanji |
author_sort |
Simona Ben-Haim |
title |
Quantitative SPECT/CT parameters of myocardial 99mTechnetium-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD) uptake in suspected cardiac transthyretin amyloidosis |
title_short |
Quantitative SPECT/CT parameters of myocardial 99mTechnetium-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD) uptake in suspected cardiac transthyretin amyloidosis |
title_full |
Quantitative SPECT/CT parameters of myocardial 99mTechnetium-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD) uptake in suspected cardiac transthyretin amyloidosis |
title_fullStr |
Quantitative SPECT/CT parameters of myocardial 99mTechnetium-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD) uptake in suspected cardiac transthyretin amyloidosis |
title_full_unstemmed |
Quantitative SPECT/CT parameters of myocardial 99mTechnetium-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD) uptake in suspected cardiac transthyretin amyloidosis |
title_sort |
quantitative spect/ct parameters of myocardial 99mtechnetium-3,3-diphosphono-1,2-propanodicarboxylic acid (dpd) uptake in suspected cardiac transthyretin amyloidosis |
publisher |
SpringerOpen |
series |
EJNMMI Research |
issn |
2191-219X |
publishDate |
2021-09-01 |
description |
Abstract Background 99mTc-labelled bisphosphonates are used for imaging assessment of patients with transthyretin cardiac amyloidosis (ATTR). Present study evaluates whether quantitative SPECT/CT measurement of absolute myocardial 99mTc-labelled 3,3-diphosphono-1,2-propanodicarboxylic acid (Tc-DPD) uptake can diagnose patients with suspected ATTR. Methods Twenty-eight patients (25 male, age 80.03 ± 6.99 years) with suspected ATTR referred for Tc-DPD imaging had planar and SPECT/CT imaging of the chest. Three operators independently obtained Tc-DPD myocardial SUVmax and SUVmean above threshold (SMaT) (20, 40 and 60% of SUVmax), using a semi-automated threshold segmentation method. Results were compared to visual grading (0–3) of cardiac uptake. Results Twenty-two patients (78%) had cardiac uptake (2 grade 1, 15 grade 2, 5 grade 3). SUVmax and SMaT segmentation thresholds enabled separating grades 2/3 from 0/1 with excellent inter- and intra-reader correlation. Cut-off values 6.0, 2.5, 3 and 4 for SUVmax, SMaT20,40,60, respectively, separated between grades 2/3 and 0 /1 with PPV and NPV of 100%. SMaT20,40,60(cardiac)/SUVmean (liver) and SMaT20,40,60(cardiac)/SUVmean(liver/lung) separated grades 2 and 3. Conclusion Quantitative SPECT/CT parameters of cardiac Tc-DPD uptake are robust, enabling separation of patients with grades 2 and 3 cardiac uptake from grades 0 and 1. Larger patient cohorts will determine the incremental value of SPECT/CT quantification for ATTR management. |
topic |
Amyloid heart disease SPECT Image analysis SPECT/CT quantitation |
url |
https://doi.org/10.1186/s13550-021-00828-0 |
work_keys_str_mv |
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