Early-phase myocardial uptake intensity of 99mTc-HMDP vs 99mTc-DPD in patients with hereditary transthyretin-related cardiac amyloidosis

2016 ◽  
Vol 25 (1) ◽  
pp. 217-222 ◽  
Author(s):  
Mukedaisi Abulizi ◽  
Anne-Ségolène Cottereau ◽  
Aziz Guellich ◽  
Stéphanie Vandeventer ◽  
Arnault Galat ◽  
...  
Keyword(s):  
Early Phase ◽  
Cardiac Amyloidosis ◽  
Myocardial Uptake

scholarly journals 373 Utility of the early phase of DPD scintigraphy in the diagnosis of correlated TT-R cardiac amyloidosis

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Tiziano Graziani ◽  
Carla Cidda ◽  
Walter Serra ◽  
Maria Mattioli ◽  
A. Sammartano ◽  
...  
Keyword(s):  
Early Phase ◽  
Cardiac Amyloidosis ◽  
Tracer Uptake ◽  
Specific Pattern ◽  
Myocardial Uptake ◽  
Tracer Injection ◽  
Cardiac Region ◽  
Planar Images ◽  
Heart To Mediastinum Ratio ◽  
Predictive Role

Abstract Aims The importance of cardiac scan with phosphonate-based radiotracers in the diagnosis of cardiac amyloidosis is now well established. Standard imaging is performed 3 h after tracer injection with a planar view on the cardiac region. This study sought to evaluate the predictive role of early-phase myocardial uptake (10 min after injection) of 99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD) compared compared with standard late acquisition, in patients with suspected hereditary transthyretin-related cardiac amyloidosis (TTR-CA). Methods and results Fifty five patients with suspected of TTR-CA with typical aspects of the relative apical sparing at two-dimensional speckle-tracking echocardiography, reported as a specific pattern for cardiac amyloidosis, were enrolled after having signed informed written consent. They have been subjected to a 99mTc-DPD cardiac scintigraphy with planar acquisition at 10 min and 3 h after tracer injection (13 Mbq/Kg). Patients with cardiac uptake on the planar images concluded the examination with a SPECT-CT (cardiac protocol) to assess the affected myocardial segments. On planar images the heart-to-mediastinum-ratio was measured. Subsequently, the diagnosis of amyloidosis has to be confirmed with morphologic examinations such as biopsy and genetic tests. Of the enrolled patients with clinical and echocardiographic aspect of TTR-CA, 22 were positive for cardiac amyloidosis. All of them showed tracer uptake in both early and late images. In patients with positive results, the early-phase showed a Heart-to-mediastinum-ratio >1.2. SPECT/CT showed involvement of almost two myocardial segments: in all patients the ventricular septum showed significant tracer uptake. Conclusions Our small group of patients showed that 99mTc-DPD myocardial uptake intensity on early-phase scintigraphy can be used to anticipate the results of late images in diagnosis of TTR cardiac amyloidosis.

scholarly journals Cardiac Amyloidosis Detected by Tc-99m (V) DMSA Myocardial Uptake

1994 ◽  
Vol 19 (12) ◽  
pp. 1109-1111 ◽  
Author(s):  
CARLO MANNI ◽  
GIUSEPPE SANGIORGI ◽  
SERGIO BOEMI ◽  
DOMENICO DE NARDO ◽  
CESIDIO CIPRIANI ◽  
...  
Keyword(s):  
Cardiac Amyloidosis ◽  
Myocardial Uptake

scholarly journals Quantification of myocardial 99mTc-labeled bisphosphonate uptake with cadmium zinc telluride camera in patients with transthyretin-related cardiac amyloidosis

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Alain Manrique ◽  
David Dudoignon ◽  
Stéphanie Brun ◽  
Catherine N’Ganoa ◽  
Emmanuelle Cassol ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Cardiac Amyloidosis ◽  
Mean Value ◽  
Whole Body ◽  
Myocardial Uptake ◽  
Whole Body Scan ◽  
Body Scan ◽  
Transthyretin Amyloidosis ◽  
Septal Thickness ◽  
Czt Spect

Abstract Purpose We aimed to compare different methods for semi-quantitative analysis of cardiac retention of bone tracers in patients with cardiac transthyretin amyloidosis (ATTR). Methods Data from 67 patients with ATTR who underwent both conventional whole-body scan and a CZT myocardial SPECT (DSPECT, Spectrum Dynamics) 3 h after injection of 99mTc-labeled bone tracer were analyzed. Visual scoring of cardiac retention was performed on whole-body scan according to Perugini 4-point grading system from 0 (no uptake) to 3 (strong cardiac uptake with mild/absent bone uptake). A planar heart-to-background (H:B) ratio was calculated using whole-body scan (wb-H:B). CZT SPECT was quantified using three methods: planar H:B ratio calculated from anterior reprojection (ant-H:B), left anterior oblique reprojection (LAO-H:B), and 3D-H:B ratio calculated from transaxial slices as mean counts in a VOI encompassing the heart divided by background VOI in the contralateral lung. Interventricular septal thickness was obtained using echocardiography. Results H:Bs obtained from planar and reprojected data were not statistically different (wb-H:B, 2.05 ± 0.64, ant-H:B, 1.97 ± 0.61, LAO-H:B, 2.06 ± 0.64, all p = ns). However, 3D-H:B was increased compared to planar H:Bs (3D-H:B, 4.06 ± 1.77, all p < 0.0001 vs. wb-H:B, ant-H:B, and LAO-H:B). Bland-Altman plots demonstrated that the difference between 3D and planar H:Bs increased with the mean value of myocardial uptake. 3D-H:B was best correlated to septal thickness (r = 0.45, p < 0.001). Finally, abnormal right ventricular uptake was associated with higher values of cardiac retention. Conclusion 3D semi-quantitative analysis of CZT SPECT optimized the assessment of 99mTc-labeled bone tracer myocardial uptake in patients with cardiac amyloidosis.

scholarly journals Positive Myocardial Uptake of Bone Scintigraphic Agents Associated with Cardiac Amyloidosis: Frequency of Positive Uptake Data Based on Daily Clinical Practice

2020 ◽  
Vol 6 (1) ◽  
pp. 27-32
Author(s):  
Shigeru Fukuzawa ◽  
Shinichi Okino ◽  
Hikaru Ishiwaki ◽  
Yo Iwata ◽  
Takashi Uchiyama ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Cardiac Amyloidosis ◽  
Daily Clinical Practice ◽  
Myocardial Uptake ◽  
Uptake Data

Does the etiology of cardiac amyloidosis determine the myocardial uptake of [18F]-NaF PET/CT?

2016 ◽  
Vol 24 (2) ◽  
pp. 746-749 ◽  
Author(s):  
Christian Gagliardi ◽  
Elena Tabacchi ◽  
Rachele Bonfiglioli ◽  
Stefania Diodato ◽  
Cristina Nanni ◽  
...  
Keyword(s):  
Cardiac Amyloidosis ◽  
Myocardial Uptake ◽  
Pet Ct

scholarly journals Early Phase 99Tc-HMDP Scintigraphy for the Diagnosis and Typing of Cardiac Amyloidosis

2017 ◽  
Vol 10 (5) ◽  
pp. 601-603 ◽  
Author(s):  
Arnault Galat ◽  
Axel Van der Gucht ◽  
Aziz Guellich ◽  
Diane Bodez ◽  
Anne-Ségolène Cottereau ◽  
...  
Keyword(s):  
Early Phase ◽  
Cardiac Amyloidosis

scholarly journals Grade 3 myocardial uptake in 99mtechnetium-pyrophosphate scintigraphy in light chain cardiac amyloidosis

2021 ◽  
Author(s):  
Atsushi Okada ◽  
Emi Tateishi ◽  
Keiko Ohta-Ogo ◽  
Chisato Izumi
Keyword(s):  
Light Chain ◽  
Cardiac Amyloidosis ◽  
Myocardial Uptake ◽  
Monoclonal Protein ◽  
Grade 3

Abstract We report grade 3 myocardial uptake in 99mtechnetium-pyrophosphate (99mTc-PYP) scintigraphy in a case of light-chain cardiac amyloidosis (CA), which emphasizes the importance of screening for monoclonal protein even in typical 99mTc-PYP findings of transthyretin CA.

scholarly journals Concordance between quantitative and semi-quantitative analysis of Tc-99m-pyrophosphate scintigraphy for the diagnosis of transthyretin cardiac amyloidosis in patients with HFpEF

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S Murat ◽  
H.E Yalvac ◽  
G.O Mert ◽  
I.A Sivrikoz ◽  
Y Cavusoglu
Keyword(s):  
Quantitative Analysis ◽  
Cardiac Amyloidosis ◽  
Low Voltage ◽  
Visual Assessment ◽  
Interatrial Septum ◽  
Left Ventricular ◽  
Myocardial Uptake ◽  
Cardiac Uptake ◽  
Funding Sources ◽  
American Society

Abstract Background Transthyretin (TTR) cardiac amyloidosis (CA) is an underdiagnosed cause of heart failure with preserved ejection fraction (HFpEF). Cardiac scintigraphy with 99mTechnetium-pyrophosphate (99mTc-PYP) is referred as a simple, non-invasive and reliable method in the diagnosis of TTR-CA. American Society of Nuclear Cardiology Practice Points recommends two interpretative approaches: the quantitative heart-to-contralateral lung ratio (H/CL) at 1 hour or the semi-quantitative visual assessment at 3 hours after radiotracer injection. Purpose In this study, we evaluated the concordance between semi-quantitative and quantitative approaches in the diagnosis of TTR CA in patients with HFpEF. Methods This single-center, prospective study included 78 patients who had a diagnosis of HFpEF according to 2016 ESC HF guidelines. 99mTc-PYP cardiac scintigraphy was performed in 43 patients who have ≥2 red flags for TTR-CA including left ventricular hypertrophy (LVH) (wall thickness ≥12 mm), biventricular hypertrophy, sparkling pattern, reduction in longitudinal strain with apical sparing, thickening of the interatrial septum (&gt;6mm), low-voltage, pseudo infarct pattern or atrioventricular block on ECG. In the absence of monoclonal protein in the serum and urine, Grade 2 to 3 myocardial uptake in semi-quantitative analysis at 3 hours or a H/CL ratio of ≥1.5 in quantitative analysis at 1 hour post injection of 99mTc-PYP is considered positive for TTR-CA. Grade 2–3 uptake with a H/CL ratio ≥1.5 or Grade 0–1 uptake with a H/CL ratio &lt;1.5 were considered as concordant results. Grade 2–3 uptake with a H/CL ratio &lt;1.5 or Grade 0–1 uptake with a H/CL ratio ≥1.5 were considered as discordant results. Results Mean age of study population was 68.26±9.97 years. 17 (39.5%) of 43 patients who underwent 99mTc-PYP cardiac scintigraphy showed a Grade 2 or 3 cardiac uptake and in these patients with Grade 2–3 uptake, 11 patients (65%) had a H/CL ratio ≥1.5 (concordant results) and 6 patients (35%) had a H/CL ratio &lt;1.5 (discordant results). 26 (60.5%) of 43 patients showed Grade 0–1 cardiac uptake. All patients (100%) with Grade 0–1 uptake had a H/CL ratio &lt;1.5 and therefore, showed concordant results. Overall, 37 (86%) patients had concordant and 6 (14%) patients had discordant results (Table 1). Conclusion The results of this study showed that although there was a high agreement between semi-quantitative and quantitative analysis of 99mTc-PYP cardiac scintigraphy, 14% of patients have discordant results and need further workup to confirm TTR-CA in patients with HFpEF. FUNDunding Acknowledgement Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Pfizer independent grant.

scholarly journals Efficient 1-Hour Technetium-99 m Pyrophosphate Imaging Protocol for the Diagnosis of Transthyretin Cardiac Amyloidosis

2020 ◽  
Vol 13 (2) ◽  
Author(s):  
Ahmad Masri ◽  
Syed Bukhari ◽  
Shahzad Ahmad ◽  
Ricardo Nieves ◽  
Yvonne S. Eisele ◽  
...  
Keyword(s):  
Cardiac Amyloidosis ◽  
Single Photon ◽  
Photon Emission ◽  
Tracer Uptake ◽  
Emission Computed Tomography ◽  
Myocardial Uptake ◽  
Planar Imaging ◽  
Imaging Protocol ◽  
Tertiary Center ◽  
Grade 3

Background: Technetium-99 m pyrophosphate protocols for transthyretin cardiac amyloidosis diagnosis have variably used 1- and 3-hour imaging time points. We investigated whether imaging at 1 hour with superior efficiency had comparable diagnostic accuracy as 3-hour imaging. Methods: This is a registry analysis of patients with suspected transthyretin cardiac amyloidosis referred for technetium-99 m pyrophosphate at a single tertiary center from June 2015 through January 2019. Patients underwent planar and single-photon emission computed tomography (SPECT) imaging at 1 and 3 hours. A positive Tc-99m pyrophosphate study was defined by the presence of diffuse myocardial tracer uptake on SPECT. For planar imaging, visual semiquantitative (grades 0-3, ≥2 considered positive) and quantitative heart to contralateral ratios (≥1.5 considered positive) were used. Results: Two hundred thirty-three patients (69% men; median age, 77 [69–83] years) underwent the study protocol. There were 60 (25.8%) patients with diffuse myocardial uptake, 1 (0.4%) with regional uptake, and 172 (73.8%) with no myocardial uptake. Results of SPECT were identical at 1 and 3 hours. Planar imaging at 1 hour had 98% sensitivity and 96% specificity. Planar grade 0 uptake or heart to contralateral ratio ≤1.2 and planar grade 3 uptake or heart to contralateral ratio ≥2.0 were always associated with negative and positive SPECT, respectively. For planar grades 1 and 2 uptake and heart to contralateral ratio 1.3 to 1.9, SPECT was needed to make a diagnosis. No patient with light-chain cardiac amyloidosis had positive SPECT. Conclusions: An efficient 1-hour technetium-99 m pyrophosphate protocol had comparable diagnostic performance to a 3-hour protocol.

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