scholarly journals Diagnostic performance of CMR, SPECT, and PET imaging for the detection of cardiac amyloidosis: a meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhaoye Wu ◽  
Chunjing Yu
Keyword(s):  
Diagnostic Performance ◽  
Clinical Decision Making ◽  
Single Photon ◽  
Meta Analysis ◽  
Photon Emission ◽  
Negative Likelihood Ratio ◽  
Myocardial Imaging ◽  
Cochrane Library ◽  
Emission Computed Tomography ◽  
Cardiac Amyloid

Abstract Background Noninvasive myocardial imaging modalities, such as cardiac magnetic resonance (CMR), single photon emission computed tomography (SPECT), and Positron emission tomography (PET), are well-established and extensively used to detect cardiac amyloid (CA). The purpose of this study is to directly compare CMR, SPECT, and PET scans in the diagnosis of CA, and to provide evidence for further scientific research and clinical decision-making. Methods PubMed, Embase, and Cochrane Library were searched. Studies used CMR, SPECT and/or PET for the diagnosis of CA were included. Pooled sensitivity, specificity, positive and negative likelihood ratio (LR), diagnostic odds ratio (DOR), their respective 95% confidence intervals (CIs) and the area under the summary receiver operating characteristic (SROC) curve (AUC) were calculated. Quality assessment of included studies was conducted. Results A total of 31 articles were identified for inclusion in this meta-analysis. The pooled sensitivities of CMR, SPECT and PET were 0.84, 0.98 and 0.78, respectively. Their respective overall specificities were 0.87, 0.92 and 0.95. Subgroup analysis demonstrated that 99mTc-HMDP manifested the highest sensitivity (0.99). 99mTc-PYP had the highest specificity (0.95). The AUC values of 99mTc-DPD, 99mTc-PYP, 99mTc-HMDP were 0.89, 0.99, and 0.99, respectively. PET scan with 11C-PIB demonstrated a pooled sensitivity of 0.91 and specificity of 0.97 with an AUC value of 0.98. Conclusion Our meta-analysis reveals that SEPCT scans present better diagnostic performance for the identification of CA as compared with other two modalities.

scholarly journals Diagnostic Performance of CMR, SPECT, and PET Imagings for the Detection of Cardiac Amyloidosis: A Meta-Analysis

2021 ◽  
Author(s):  
Zhaoye Wu ◽  
Chunjing Yu
Keyword(s):  
Diagnostic Performance ◽  
Clinical Decision Making ◽  
Single Photon ◽  
Meta Analysis ◽  
Photon Emission ◽  
Negative Likelihood Ratio ◽  
Myocardial Imaging ◽  
Cochrane Library ◽  
Emission Computed Tomography ◽  
Cardiac Amyloid

Abstract Background: Noninvasive myocardial imaging modalities, such as cardiac magnetic resonance (CMR), single photon emission computed tomography (SPECT), and Positron emission tomography (PET), are well-established and extensively used to detect cardiac amyloid (CA). The purpose of this study is to directly compare CMR, SPECT, and PET scans in the diagnosis of CA, and to provide evidence for further scientific research and clinical decision-making.Methods: PubMed, Embase, and Cochrane Library were searched. Studies used CMR, SPECT and/or PET for the diagnosis of CA were included. Pooled sensitivity, specificity, positive and negative likelihood ratio (LR), diagnostic odds ratio (DOR), their respective 95% confidence intervals (CIs) and the area under the summary receiver operating characteristic (SROC) curve (AUC) were calculated. Quality assessment of included studies was conducted.Results: A total of 31 articles were identified for inclusion in this meta-analysis. The pooled sensitivities of CMR, SPECT and PET was 0.84, 0.98 and 0.78, respectively. Their respective overall specificities were 0.87, 0.92 and 0.83. Subgroup analysis demonstrated that 99mTc-HMDP manifested the highest sensitivity (0.99). 99mTc-PYP had the highest specificity (0.95). The AUC values of 99mTc-DPD, 99mTc-PYP, 99mTc-HMDP were 0.89, 0.99, and 0.99, respectively. PET scan with 11C-PIB demonstrated a pooled sensitivity of 0.91 and specificity of 0.97 with an AUC value of 0.98.Conclusion: Our meta-analysis reveals that SEPCT scans present better diagnostic performance for the identification of CA as compared with other two modalities.

scholarly journals Diagnostic Performance of CMR, SPECT, and PET Imaging for the Identification of Coronary Artery Disease: A Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Jianfeng Xu ◽  
Fei Cai ◽  
Changran Geng ◽  
Zheng Wang ◽  
Xiaobin Tang
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Likelihood Ratio ◽  
Subgroup Analysis ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Diagnostic Methods ◽  
Cochrane Library ◽  
Emission Computed Tomography ◽  
Artery Disease

Background: Myocardial perfusion imaging modalities, such as cardiac magnetic resonance (CMR), single-photon emission computed tomography (SPECT), and positron emission tomography (PET), are well-established non-invasive diagnostic methods to detect hemodynamically significant coronary artery disease (CAD). The aim of this meta-analysis is to compare CMR, SPECT, and PET in the diagnosis of CAD and to provide evidence for further research and clinical decision-making.Methods: PubMed, Web of Science, EMBASE, and Cochrane Library were searched. Studies that used CMR, SPECT, and/or PET for the diagnosis of CAD were included. Pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio with their respective 95% confidence interval, and the area under the summary receiver operating characteristic (SROC) curve were calculated.Results: A total of 203 articles were identified for inclusion in this meta-analysis. The pooled sensitivity values of CMR, SPECT, and PET were 0.86, 0.83, and 0.85, respectively. Their respective overall specificity values were 0.83, 0.77, and 0.86. Results in subgroup analysis of the performance of SPECT with 201Tl showed the highest pooled sensitivity [0.85 (0.82, 0.88)] and specificity [0.80 (0.75, 0.83)]. 99mTc-tetrofosmin had the lowest sensitivity [0.76 (0.67, 0.82)]. In the subgroup analysis of PET tracers, results indicated that 13N had the lowest pooled sensitivity [0.83 (0.74, 0.89)], and the specificity was the highest [0.91 (0.81, 0.96)].Conclusion: Our meta-analysis indicates that CMR and PET present better diagnostic performance for the detection of CAD as compared with SPECT.

Normal Pressure Hydrocephalus with Primary Presentation of Psychiatric Disturbance: Case Report

2019 ◽  
Vol 80 (05) ◽  
pp. 404-408
Author(s):  
Michael Kogan ◽  
Justice Agyei ◽  
Kevin J. Cuddahee ◽  
Kevin J. Gibbons
Keyword(s):  
Case Report ◽  
Normal Pressure Hydrocephalus ◽  
Clinical Decision Making ◽  
Single Photon ◽  
Obstructive Hydrocephalus ◽  
Photon Emission ◽  
Normal Pressure ◽  
Future Research ◽  
Emission Computed Tomography ◽  
Psychiatric Disturbance

Background and Objective Progressive impairment of cognitive function is a common feature seen in patients with normal pressure hydrocephalus (NPH). Along with cognitive decline, many of the other classic symptoms of NPH are chronic and rarely present with overwhelming anxiety. We report the case of a 63-year-old man who presented with recent primary psychiatric manifestation of severe disabling anxiety and otherwise a minimal change in gait and no urinary disturbance. Clinical Presentation The patient's work-up consisted of magnetic resonance imaging that showed moderate ventriculomegaly but no findings concerning for acute obstructive hydrocephalus. A single-photon emission computed tomography scan was markedly abnormal with severe hypoperfusion consistent with hydrocephalus. Initially shunting was not advised but was eventually performed after a dramatic response to a large-volume lumbar puncture. After considerable discussion, he underwent elective ventriculoperitoneal shunt placement and had dramatic and sustained improvement in his anxiety. Conclusion We believe this case report is a unique description of NPH symptomology and might guide future research or clinical decision making.

scholarly journals Comparison of 99mTc-Labeled Colloid SPECT/CT and Planar Lymphoscintigraphy in Sentinel Lymph Node Detection in Patients with Melanoma: A Meta-Analysis

2020 ◽  
Vol 9 (6) ◽  
pp. 1680
Author(s):  
Natale Quartuccio ◽  
Ludovico Maria Garau ◽  
Annachiara Arnone ◽  
Marco Pappalardo ◽  
Domenico Rubello ◽  
...  
Keyword(s):  
Relative Risk ◽  
Single Photon ◽  
Meta Analysis ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Average Impact ◽  
Single Photon Emission Computed ◽  
The Impact ◽  
Photon Emission Computed Tomography ◽  
Planar Lymphoscintigraphy

We compared the detection rate (DR) for sentinel lymph nodes (SLNS), the number of SLNs and the subjects with additional SLNs of single-photon emission computed tomography (SPECT/CT) and planar lymphoscintigraphy (PL) in patients with melanoma. Furthermore, we evaluated the impact of SPECT/CT on surgical plans. Articles containing head-to-head comparisons between SPECT/CT and PL were searched in Pubmed/MEDLINE and Scopus. The literature search was updated until December 31st, 2019. DR was calculated on a per-patient-based analysis; the studies were pooled by their odds ratios (ORs) with a random effects model to assess the significance of difference (p < 0.05). The number of additional SLNs (calculated as the relative risk) and pooled proportion of patients with additional SLNs were investigated. The pooled ratio of surgical procedures influenced by the SPECT/CT findings was calculated. Seventeen studies with 1438 patients were eligible for the calculation of DR of SPECT/CT and PL. The average DR was 98.28% (95% confidence interval (95% CI): 97.94–99.19%) for the SPECT/CT and 95.53% (95% CI: 92.55–97.77%) for the PL; OR of 2.31 (95% CI: 1.66–4.18, p < 0.001) in favor of the SPECT/CT. There was a relative risk of a higher number of SLNs (1.13) for the SPECT/CT and 17.87% of patients with additional SLNs were detected by SPECT/CT. The average impact of SPECT/CT on surgery resulted in 37.43% of cases. This meta-analysis favored SPECT/CT over PL for the identification of SLNs in patients with melanoma due to a higher DR, reproducibility, number of SLNs depicted, proportion of patients with additional SLNs and the impact on the surgical plan. However, PL remains a good option due to the high values of the DR for SLNs.

scholarly journals Development of Antibody Immuno-PET/SPECT Radiopharmaceuticals for Imaging of Oncological Disorders—An Update

Cancers ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1868
Author(s):  
Jonatan Dewulf ◽  
Karuna Adhikari ◽  
Christel Vangestel ◽  
Tim Van Den Wyngaert ◽  
Filipe Elvas
Keyword(s):  
Clinical Decision Making ◽  
Single Photon ◽  
Imaging Techniques ◽  
Photon Emission ◽  
Therapy Response ◽  
High Specificity ◽  
Clinical Decision ◽  
Disease Diagnosis ◽  
Emission Computed Tomography ◽  
Wide Range

Positron emission tomography (PET) and single-photon emission computed tomography (SPECT) are molecular imaging strategies that typically use radioactively labeled ligands to selectively visualize molecular targets. The nanomolar sensitivity of PET and SPECT combined with the high specificity and affinity of monoclonal antibodies have shown great potential in oncology imaging. Over the past decades a wide range of radio-isotopes have been developed into immuno-SPECT/PET imaging agents, made possible by novel conjugation strategies (e.g., site-specific labeling, click chemistry) and optimization and development of novel radiochemistry procedures. In addition, new strategies such as pretargeting and the use of antibody fragments have entered the field of immuno-PET/SPECT expanding the range of imaging applications. Non-invasive imaging techniques revealing tumor antigen biodistribution, expression and heterogeneity have the potential to contribute to disease diagnosis, therapy selection, patient stratification and therapy response prediction achieving personalized treatments for each patient and therefore assisting in clinical decision making.

scholarly journals Impact of age, sex, and cardiac size on the diagnostic performance of myocardial perfusion single-photon emission computed tomography: insights from the REFINE SPECT registry

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
M J Randazzo ◽  
P Elias ◽  
T J Poterucha ◽  
T Sharir ◽  
M B Fish ◽  
...  
Keyword(s):  
Myocardial Perfusion ◽  
Elderly Patients ◽  
Diagnostic Performance ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Spect Mpi ◽  
Significant Difference ◽  
Cardiac Volumes ◽  
Photon Emission Computed Tomography

Abstract Background Single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI) is a well-validated non-invasive method for detecting coronary artery disease (CAD). Variations in diagnostic performance due to age and sex have been thoroughly investigated in the literature yet have demonstrated conflicting results. Several studies have associated female sex with reduced accuracy, although others have discovered no significant difference (1). Similarly, while SPECT MPI in the elderly has shown prognostic utility, cardiac event rates are elevated compared to younger patients despite a normal study (2). Additional analyses have suggested that cardiac chamber size may contribute to these observed differences due to its relationship with spatial resolution; however, the interaction of age, sex, and cardiac size remains unknown. Purpose We aimed to leverage a large, multicenter, international registry to assess the impact of age, sex, and left ventricular size on the diagnostic accuracy of contemporary SPECT MPI. Methods In 9 centers, 2067 patients (67% male, 64.7±11.2 years) in the REFINE SPECT database (REgistry of Fast Myocardial Perfusion Imaging with NExt Generation SPECT) underwent MPI with new generation solid-state scanners followed by invasive coronary angiography within 6 months (3). Stress total perfusion deficit was quantified automatically, and obstructive CAD was defined as &gt;70% stenosis or &gt;50% for left main. Receiver-operating characteristic curves and corresponding areas under the curve (AUC) were computed to compare diagnostic performance between cohorts created based on age (&lt;75 vs. ≥75 years), sex, and end-diastolic volume (EDV; ≥20th vs. &lt;20th sex-specific percentile). Results Female and elderly patients had a significantly lower EDV than male and younger patients respectively (p&lt;0.001, Figure 1). Diagnostic accuracy of SPECT was similar by sex (p=0.63). Elderly patients (AUC 0.72 vs. 0.78, p=0.025) and patients with reduced volumes (AUC 0.72 vs. 0.79, p=0.009) exhibited significantly worse performance. When isolating male patients with reduced volumes, a significant difference in accuracy was observed (AUC 0.69 vs. 0.79, p=0.001; Figure 2A), while female patients trended towards significance (p=0.32). Likewise, SPECT performed poorly for elderly patients with reduced volumes (AUC 0.64 vs. 0.78, p=0.01; Figure 2B). If patients possessed any two characteristics of male sex, age ≥75, or low EDV, prediction of CAD with SPECT was significantly decreased (p=0.002; Figure 2C). Conclusions Our findings suggest that men with reduced cardiac volumes display worse diagnostic SPECT performance, although it is uncertain whether a pathophysiologic reason exists or further investigation is required for female patients. Patients age ≥75 tended to have lower cardiac volumes as well as lower diagnostic performance. Given these results, alternative diagnostic modalities may better diagnose CAD in patients with these characteristics. FUNDunding Acknowledgement Type of funding sources: None. Figure 1 Figure 2

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