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.

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 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.

scholarly journals Shortened Tracer Uptake Time in GA-68-DOTATOC-PET of Meningiomas Does Not Impair Diagnostic Accuracy and PET Volume Definition

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1084
Author(s):  
Josefine Graef ◽  
Carolin Senger ◽  
Christoph Wetz ◽  
Alexander D. J. Baur ◽  
Anne K. Kluge ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Target Volume ◽  
Tracer Uptake ◽  
Lesion Detection ◽  
Rank Test ◽  
Tracer Injection ◽  
Signed Rank ◽  
Signed Rank Test ◽  
Definition Of ◽  
Time Point

Ga-68-DOTATOC-PET/MRI can affect the planning target volume (PTV) definition of meningiomas before radiosurgery. A shorter tracer uptake time before image acquisition could allow the examination of more patients. The aim of this study was to investigate if shortening uptake time is possible without compromising diagnostic accuracy and PET volume. Fifteen patients (f = 12; mean age 52 years (34–80 years)) with meningiomas were prospectively examined with dynamic [68Ga]Ga-68-labeled [DOTA0-Phe1-Tyr3] octreotide (Ga-68-DOTATOC)-PET/MRI over 70 min before radiosurgery planning. Meningiomas were delineated manually in the PET dataset. PET volumes at each time point were compared to the reference standard 60 min post tracer injection (p.i.) using the Friedman test followed by a Wilcoxon signed-rank test and Bonferroni correction. In all patients, the earliest time point with 100% lesion detection compared to 60 min p.i. was identified. PET volumes did not change significantly from 15 min p.i. (p = 1.0) compared to 60 min p.i. The earliest time point with 100% lesion detection in all patients was 10 min p.i. In patients with meningiomas undergoing Ga-68-DOTATOC-PET, the tracer uptake time can safely be reduced to 15 min p.i. with comparable PET volume and 100% lesion detection compared to 60 min p.i.

Abstract 3193: First Preclinical Study of a New F-18 Labeled PET Tracer for Myocardial Perfusion Imaging

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Marc Huisman ◽  
Takahiro Higuchi ◽  
Sybille Reder ◽  
Stephan Nekolla ◽  
Thorsten Poethko ◽  
...  
Keyword(s):  
Myocardial Perfusion Imaging ◽  
Myocardial Perfusion ◽  
Perfusion Imaging ◽  
Preclinical Study ◽  
Left Ventricular ◽  
Tracer Uptake ◽  
Left Ventricular Cavity ◽  
Myocardial Uptake ◽  
Extraction Fraction ◽  
First Pass

Introduction: An F-18 based myocardial perfusion imaging (MPI) tracer would increase the availability of tracers for cardiac PET/CT exams at stand-alone PET facilities. Hypothesis: F-18 labeled BMS-747158 – 02 is a promising tracer for MPI. Methods: All studies were carried out in healthy male Wistar rats (275 ± 25 g). The biodistribution of F-18 BMS-747158 – 02 was obtained 10 and 60 minutes post injection (p.i.). The first pass extraction fraction of the tracer was determined according to the Langendorff method. ECG gated microPET imaging (FOCUS F-120, Siemens Medical Imaging, USA) was performed, and the listmode data were sorted into dynamic sinograms corresponding to the diastolic phase of the heart cycle. After reorientation of the data time activity curves (TACs) were derived for the left ventricular cavity and myocardium, as well as tracer uptake polar maps two minutes p.i.. Rats were measured under MMF anesthesia, either during rest (n = 6) or during adenosine induced stress conditions (n = 6). Tracer retention two minutes p.i. was defined as tracer uptake divided through the integral under the input function. Results: The biodistribution of F-18 BMS-747158 – 02 is favorable for cardiac imaging: high myocardial uptake (3.1 %ID/g) combines with low uptake in lung and liver (0.3 %ID/g and 1.0 %ID/g, respectively, 10 minutes p.i. (n = 3)). The myocardial uptake is homogeneous (the average means equal 77.4 ± 6.0 % and 77.8 ± 7.8 % of the maximum uptake for the rest and stress groups, respectively). The tracer shows a high and flow independent myocardial first pass extraction fraction, averaging 0.94 ± 0.04 (3 flow velocities, n >= 3 per group). Adenosine infusion (140 μg/kg/min) leads to a significant increase in myocardial tracer retention (1.68 ± 0.23 sec −1 to 3.21 ± 0.92 sec −1 ; P = 0.03). Conclusions: F-18 labeled BMS-747158 – 02 shows high extraction combined with excellent imaging characteristics in this first preclinical study of its applicability as a PET MPI agent.

scholarly journals The renal transplant score: A different way of evaluating renal transplant pathology

1997 ◽  
Vol 2 (2) ◽  
pp. 16-18
Author(s):  
R. P. Clauss ◽  
A. Kobryn
Keyword(s):  
Pilot Study ◽  
Renal Transplant ◽  
Acute Rejection ◽  
Radionuclide Imaging ◽  
Chronic Rejection ◽  
Tracer Uptake ◽  
Hyperacute Rejection ◽  
Tracer Injection ◽  
And Function

The renal transplant is a notoriously difficult organ to assess for pathology. Radionuclide imaging can help, but, although sensitive, the evaluation is not very specific. For this reason, a different approach was used to examine renal images and results were correlated with histology. The transplant score is determined from images of perfusion and function on certain criteria such as time of appearance of the kidney after tracer injection, intensity of background, size and homogeneity of tracer uptake by the kidney. Although small, the pilot study could distinguish between hyperacute rejection, acute rejection, chronic rejection and cyclosporin toxicity.

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 Absent 99mTc-MIBI Uptake in the Thyroid Gland during Early Phase of Parathyroid Scintigraphy in Patients with Primary and Secondary Hyperparathyroidism

2018 ◽  
Vol 6 (5) ◽  
pp. 808-813 ◽  
Author(s):  
Anamarija Jovanovska ◽  
Bojana Stoilovska ◽  
Magdalena Mileva ◽  
Daniela Miladinova ◽  
Venjamin Majstorov ◽  
...  
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Thyroid Gland ◽  
Thyroid Disease ◽  
Early Phase ◽  
Dual Phase ◽  
Parathyroid Scintigraphy ◽  
Thyroid Uptake ◽  
Planar Images ◽  
99Mtc Mibi

BACKGROUND: Thyroid uptake of technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) during parathyroid scintigraphy can be affected by various conditions.AIM: To evaluate the frequency of absent 99mTc-MIBI uptake by the thyroid gland in the early phase of dual-phase parathyroid scintigraphy.METHODS: The early planar images of dual phase Tc99m MIBI parathyroid scintigraphy from 217 patients performed between 2014 and 2017 were retrospectively analysed. Patients were divided into two groups. The first group included 147 patients with primary hyperparathyroidism and the second group included 70 patients with chronic renal failure. Patient records, laboratory and ultrasonographic data were analysed in all patients. Descriptive statistic was used for data analysis.RESULTS: Out of all patients in the first group, 18 patients (12.24%) showed absent thyroid uptake. Thyroidectomy was performed in 44.4% of these patients, and the rest of them had some thyroid disease. Only one patient had no thyroid or another chronic disease. In the second group, 8 patients (11.42%) presented with absent thyroid uptake of MIBI. Among them, 5 patients had no history of thyroid disease and had been on hemodialysis programme, and 3 patients had hypothyroidism.CONCLUSION: Absent 99mTc-MIBI uptake in the thyroid during the early phase of parathyroid scintigraphy is most frequently related to thyroid disease. A small proportion of patients with chronic renal failure can present with absent 99mTc-MIBI uptake in the thyroid as well. The mechanism for this alteration is still unclear and needs further investigation.

scholarly journals MLTI-18. PRECISION IMAGING OF METASTATIC AND PRIMARY BRAIN TUMORS AFTER RADIATION WITH 18F-FDOPA PET-MRI IS FEASIBLE AND COST EFFECT

2019 ◽  
Vol 1 (Supplement_1) ◽  
pp. i18-i18
Author(s):  
Mariam Aboian ◽  
Vahid Ravanfar ◽  
Emma Bahroos ◽  
Elizabeth Tong ◽  
Jennie Taylor ◽  
...  
Keyword(s):  
Tumor Recurrence ◽  
Metastatic Breast ◽  
Cost Savings ◽  
Cost Effective ◽  
Tracer Uptake ◽  
Recurrent Glioblastoma ◽  
Synthesis Process ◽  
Tracer Injection ◽  
Sagittal Sinus ◽  
Pet Tracer

Abstract PURPOSE: Post-radiation changes in the brain can mimic tumor recurrence on MRI, requiring multiple short term follow-ups to differentiate tumor progression from radiation necrosis. We propose combining functional and anatomic imaging with FDOPA PET tracer in hybrid PET-MRI to improve detection of tumor recurrence. MATERIALS AND METHODS: Seventeen adult patients treated with radiation therapy were identified - four with metastatic disease from breast and lung cancer and thirteen with primary brain glioma (11 IDH wildtype glioblastoma and 2 astrocytoma). Patients were scanned on hybrid PET-MRI (GE Healthcare) with clinical MRI brain sequences and dynamic FDOPA uptake. Dynamic FDOPA uptake within these tumors over 45 minutes after tracer injection was analyzed and compared to ADC histogram analysis. RESULTS: For each of the patients, clinical multi sequence gadolinium enhanced MRI and dynamic PET imaging for up to 45 minutes with 18F-FDOPA amino acid tracer was obtained. The total cost savings of scanning 17 patients in groups was 51.4% ($28,321), as opposed to the cost of individual radiosynthesis performed for each study. Quantitative analysis of tracer uptake in striatum, internal carotid artery, and superior sagittal sinus were performed with appropriate accumulation and subsequent washout of tracer respectively. Successful dynamic FDOPA uptake within the tumor was seen in all patients and ratio of tumor to contralateral ROI were found to range from 1.8–4.5. While raw SUV values did not differentiate between recurrent tumor and radiation changes, T/C SUVmax ratios were elevated to 4.5 in recurrent glioblastoma, 2.5 in hypoxic treated glioblastoma, and 1.8 in non-recurrent metastatic breast cancer after gamma knife treatment. CONCLUSION: Batch imaging of patients with [18F]FDOPA PET-MRI is feasible and cost effective. Understanding radionuclide synthesis process is critical for increasing accessibility of novel PET tracers to patients and results in significant cost savings.

Intraindividual comparison of selective intraarterial versus systemic intravenous 68Ga-DOTATATE PET/CT in patients with inoperable meningioma

2019 ◽  
Vol 58 (01) ◽  
pp. 23-27 ◽  
Author(s):  
Frederik A. Verburg ◽  
Martin Wiessmann ◽  
Georg Neuloh ◽  
Felix M. Mottaghy ◽  
Marc-Alexander Brockmann
Keyword(s):  
Standardized Uptake Value ◽  
Peptide Receptor Radionuclide Therapy ◽  
Tracer Uptake ◽  
Liver Uptake ◽  
Tracer Injection ◽  
Who Grade ◽  
Intraindividual Comparison ◽  
Pet Ct ◽  
Grade Ii ◽  
Who Grade Ii Meningioma

Abstract Aim Here we describe the results of superselective intraarterial application of diagnostic Ga-68-DOTA0,Tyr3-octreotate (Ga-68-DOTATATE) in a series of patients with inoperable WHO grade II meningiomas which were no longer amenable to radiotherapy. Methods Four patients with inoperable WHO grade II meningioma underwent systemic venous infusion of Ga-68-DOTATATE followed by PET/CT. Ga-68-DOTATATE application was repeated intraarterially via transfemoral catheterization of vessels supplying the meningioma and another PET/CT was performed. Results Selective arterial infusion of Ga-68-DOTATATE increased the median value for the maximum standardized uptake value (SUV) by 2.6-fold (median venous: 7.1, median arterial: 21.6; range 2.0–5.0) and the median value for mean SUV by 2.7-fold (median venous: 4.3, median arterial: 11.2; range 1.6–5.6) compared to systemic intravenous infusion. Arterial application was well tolerated by all patients without complications. When compared to liver uptake, intravenous tracer uptake was insufficient for PRRT, whereas tracer uptake after superselective intraarterial tracer injection was sufficient to allow for peptide receptor radionuclide therapy (PRRT) in all patients. Conclusion Insufficient tracer uptake in meningiomas after intravenous application of Ga-68-DOTATATE may be safely increased by a factor of 2–5 using transfemoral selective intraarterial tracer application.

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.

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