Splenic switch-off in regadenoson 82Rb-PET myocardial perfusion imaging: assessment of clinical utility
Splenic switch-off (SSO) is a phenomenon describing a decrease in splenic radiotracer uptake after vasodilatory stress. We aimed to assess the diagnostic utility of regadenoson-induced SSO. We included consecutive patients who had clinically indicated Regadenoson Rb-82 PET-MPI for suspected CAD. Thi...
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| Veröffentlicht in: | Journal of nuclear cardiology 2023-08, Vol.30 (4), p.1484-1496 |
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| container_title | Journal of nuclear cardiology |
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| creator | Saad, Jean Michel Ahmed, Ahmed Ibrahim Han, Yushui El Nihum, Lamees I. Alahdab, Fares Nabi, Faisal Al-Mallah, Mouaz H. |
| description | Splenic switch-off (SSO) is a phenomenon describing a decrease in splenic radiotracer uptake after vasodilatory stress. We aimed to assess the diagnostic utility of regadenoson-induced SSO.
We included consecutive patients who had clinically indicated Regadenoson Rb-82 PET-MPI for suspected CAD. This derivation cohort (no perfusion defects and myocardial flow reserves (MFR) ≥ 2) was used to calculate the splenic response ratio (SRR). The validation cohort was defined as patients who underwent both PET-MPI studies and invasive coronary angiography (ICA).
The derivation cohort (n = 100, 57.4 ± 11.6 years, 77% female) showed a decrease in splenic uptake from rest to stress (79.9 ± 16.8 kBq⋅mL vs 69.1 ± 16.2 kBq⋅mL, P < .001). From the validation cohort (n = 315, 66.3 ± 10.4 years, 67% male), 28% (via SRR = 0.88) and 15% (visually) were classified as splenic non-responders. MFR was lower in non-responders (SRR; 1.55 ± 0.65 vs 1.76 ± 0.78, P = .02 and visually; 1.18 ± 0.33 vs 1.79 ± 0.77, P < .001). Based on ICA, non-responders were more likely to note obstructive epicardial disease with normal PET scans especially in patients with MFR < 1.5 (SRR; 61% vs 34% P = .05 and visually; 68% vs 33%, P = .01).
Lack of splenic response based on visual or quantitative assessment of SSO may be used to identify an inadequate vasodilatory response. |
| doi_str_mv | 10.1007/s12350-022-03158-3 |
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We included consecutive patients who had clinically indicated Regadenoson Rb-82 PET-MPI for suspected CAD. This derivation cohort (no perfusion defects and myocardial flow reserves (MFR) ≥ 2) was used to calculate the splenic response ratio (SRR). The validation cohort was defined as patients who underwent both PET-MPI studies and invasive coronary angiography (ICA).
The derivation cohort (n = 100, 57.4 ± 11.6 years, 77% female) showed a decrease in splenic uptake from rest to stress (79.9 ± 16.8 kBq⋅mL vs 69.1 ± 16.2 kBq⋅mL, P < .001). From the validation cohort (n = 315, 66.3 ± 10.4 years, 67% male), 28% (via SRR = 0.88) and 15% (visually) were classified as splenic non-responders. MFR was lower in non-responders (SRR; 1.55 ± 0.65 vs 1.76 ± 0.78, P = .02 and visually; 1.18 ± 0.33 vs 1.79 ± 0.77, P < .001). Based on ICA, non-responders were more likely to note obstructive epicardial disease with normal PET scans especially in patients with MFR < 1.5 (SRR; 61% vs 34% P = .05 and visually; 68% vs 33%, P = .01).
Lack of splenic response based on visual or quantitative assessment of SSO may be used to identify an inadequate vasodilatory response.</description><identifier>ISSN: 1071-3581</identifier><identifier>EISSN: 1532-6551</identifier><identifier>DOI: 10.1007/s12350-022-03158-3</identifier><language>eng</language><publisher>Cham: Elsevier Inc</publisher><subject>Cardiology ; Imaging ; Medicine ; Medicine & Public Health ; Myocardial perfusion imaging ; Nuclear Medicine ; Original Article ; positron emission tomography ; Radiology ; regadenoson ; spleen ; splenic switch-off ; vasodilatory agent</subject><ispartof>Journal of nuclear cardiology, 2023-08, Vol.30 (4), p.1484-1496</ispartof><rights>2023 American Society of Nuclear Cardiology. Published by ELSEVIER INC. All rights reserved.</rights><rights>The Author(s) under exclusive licence to American Society of Nuclear Cardiology 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c335t-c6c4bd0848fb72d4e0039963b794bc799c8d93b83944901d9314631dea0096603</citedby><cites>FETCH-LOGICAL-c335t-c6c4bd0848fb72d4e0039963b794bc799c8d93b83944901d9314631dea0096603</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12350-022-03158-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12350-022-03158-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids></links><search><creatorcontrib>Saad, Jean Michel</creatorcontrib><creatorcontrib>Ahmed, Ahmed Ibrahim</creatorcontrib><creatorcontrib>Han, Yushui</creatorcontrib><creatorcontrib>El Nihum, Lamees I.</creatorcontrib><creatorcontrib>Alahdab, Fares</creatorcontrib><creatorcontrib>Nabi, Faisal</creatorcontrib><creatorcontrib>Al-Mallah, Mouaz H.</creatorcontrib><title>Splenic switch-off in regadenoson 82Rb-PET myocardial perfusion imaging: assessment of clinical utility</title><title>Journal of nuclear cardiology</title><addtitle>J. Nucl. Cardiol</addtitle><description>Splenic switch-off (SSO) is a phenomenon describing a decrease in splenic radiotracer uptake after vasodilatory stress. We aimed to assess the diagnostic utility of regadenoson-induced SSO.
We included consecutive patients who had clinically indicated Regadenoson Rb-82 PET-MPI for suspected CAD. This derivation cohort (no perfusion defects and myocardial flow reserves (MFR) ≥ 2) was used to calculate the splenic response ratio (SRR). The validation cohort was defined as patients who underwent both PET-MPI studies and invasive coronary angiography (ICA).
The derivation cohort (n = 100, 57.4 ± 11.6 years, 77% female) showed a decrease in splenic uptake from rest to stress (79.9 ± 16.8 kBq⋅mL vs 69.1 ± 16.2 kBq⋅mL, P < .001). From the validation cohort (n = 315, 66.3 ± 10.4 years, 67% male), 28% (via SRR = 0.88) and 15% (visually) were classified as splenic non-responders. MFR was lower in non-responders (SRR; 1.55 ± 0.65 vs 1.76 ± 0.78, P = .02 and visually; 1.18 ± 0.33 vs 1.79 ± 0.77, P < .001). Based on ICA, non-responders were more likely to note obstructive epicardial disease with normal PET scans especially in patients with MFR < 1.5 (SRR; 61% vs 34% P = .05 and visually; 68% vs 33%, P = .01).
Lack of splenic response based on visual or quantitative assessment of SSO may be used to identify an inadequate vasodilatory response.</description><subject>Cardiology</subject><subject>Imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Myocardial perfusion imaging</subject><subject>Nuclear Medicine</subject><subject>Original Article</subject><subject>positron emission tomography</subject><subject>Radiology</subject><subject>regadenoson</subject><subject>spleen</subject><subject>splenic switch-off</subject><subject>vasodilatory agent</subject><issn>1071-3581</issn><issn>1532-6551</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kE1LHTEUhoeiUD_6B7oKdOMmNZ8zSXEjoq0gKGrXYSZzZhqZm1xzZpT77007hUIXrnIgz_NyzltVnzn7yhlrTpELqRllQlAmuTZUfqgOuJaC1lrzvTKzhlOpDf9YHSI-McastPagGh-2E8TgCb6G2f-iaRhIiCTD2PYQE6ZIjLjv6N3lI9nskm9zH9qJbCEPC4byGzbtGOL4jbSIgLiBOJM0ED-FklrIZQ5TmHfH1f7QTgif_r5H1c-ry8eLH_Tm9vv1xfkN9VLqmfraq65nRpmha0SvgLGyZi27xqrON9Z601vZGWmVsoyXmata8h7aclBdM3lUnay525yeF8DZbQJ6mKY2QlrQiabm1mhtTEG__Ic-pSXHsp0TRgmtlKqbQomV8jkhZhjcNpeb885x5n5379buXene_eneySLJVcICxxHyv-h3rbPVglLQSygW-gDRQx8y-Nn1KbynvwEdBplT</recordid><startdate>20230801</startdate><enddate>20230801</enddate><creator>Saad, Jean Michel</creator><creator>Ahmed, Ahmed Ibrahim</creator><creator>Han, Yushui</creator><creator>El Nihum, Lamees I.</creator><creator>Alahdab, Fares</creator><creator>Nabi, Faisal</creator><creator>Al-Mallah, Mouaz H.</creator><general>Elsevier Inc</general><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20230801</creationdate><title>Splenic switch-off in regadenoson 82Rb-PET myocardial perfusion imaging: assessment of clinical utility</title><author>Saad, Jean Michel ; Ahmed, Ahmed Ibrahim ; Han, Yushui ; El Nihum, Lamees I. ; Alahdab, Fares ; Nabi, Faisal ; Al-Mallah, Mouaz H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c335t-c6c4bd0848fb72d4e0039963b794bc799c8d93b83944901d9314631dea0096603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Cardiology</topic><topic>Imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Myocardial perfusion imaging</topic><topic>Nuclear Medicine</topic><topic>Original Article</topic><topic>positron emission tomography</topic><topic>Radiology</topic><topic>regadenoson</topic><topic>spleen</topic><topic>splenic switch-off</topic><topic>vasodilatory agent</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Saad, Jean Michel</creatorcontrib><creatorcontrib>Ahmed, Ahmed Ibrahim</creatorcontrib><creatorcontrib>Han, Yushui</creatorcontrib><creatorcontrib>El Nihum, Lamees I.</creatorcontrib><creatorcontrib>Alahdab, Fares</creatorcontrib><creatorcontrib>Nabi, Faisal</creatorcontrib><creatorcontrib>Al-Mallah, Mouaz H.</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of nuclear cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Saad, Jean Michel</au><au>Ahmed, Ahmed Ibrahim</au><au>Han, Yushui</au><au>El Nihum, Lamees I.</au><au>Alahdab, Fares</au><au>Nabi, Faisal</au><au>Al-Mallah, Mouaz H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Splenic switch-off in regadenoson 82Rb-PET myocardial perfusion imaging: assessment of clinical utility</atitle><jtitle>Journal of nuclear cardiology</jtitle><stitle>J. Nucl. Cardiol</stitle><date>2023-08-01</date><risdate>2023</risdate><volume>30</volume><issue>4</issue><spage>1484</spage><epage>1496</epage><pages>1484-1496</pages><issn>1071-3581</issn><eissn>1532-6551</eissn><abstract>Splenic switch-off (SSO) is a phenomenon describing a decrease in splenic radiotracer uptake after vasodilatory stress. We aimed to assess the diagnostic utility of regadenoson-induced SSO.
We included consecutive patients who had clinically indicated Regadenoson Rb-82 PET-MPI for suspected CAD. This derivation cohort (no perfusion defects and myocardial flow reserves (MFR) ≥ 2) was used to calculate the splenic response ratio (SRR). The validation cohort was defined as patients who underwent both PET-MPI studies and invasive coronary angiography (ICA).
The derivation cohort (n = 100, 57.4 ± 11.6 years, 77% female) showed a decrease in splenic uptake from rest to stress (79.9 ± 16.8 kBq⋅mL vs 69.1 ± 16.2 kBq⋅mL, P < .001). From the validation cohort (n = 315, 66.3 ± 10.4 years, 67% male), 28% (via SRR = 0.88) and 15% (visually) were classified as splenic non-responders. MFR was lower in non-responders (SRR; 1.55 ± 0.65 vs 1.76 ± 0.78, P = .02 and visually; 1.18 ± 0.33 vs 1.79 ± 0.77, P < .001). Based on ICA, non-responders were more likely to note obstructive epicardial disease with normal PET scans especially in patients with MFR < 1.5 (SRR; 61% vs 34% P = .05 and visually; 68% vs 33%, P = .01).
Lack of splenic response based on visual or quantitative assessment of SSO may be used to identify an inadequate vasodilatory response.</abstract><cop>Cham</cop><pub>Elsevier Inc</pub><doi>10.1007/s12350-022-03158-3</doi><tpages>13</tpages></addata></record> |
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| subjects | Cardiology Imaging Medicine Medicine & Public Health Myocardial perfusion imaging Nuclear Medicine Original Article positron emission tomography Radiology regadenoson spleen splenic switch-off vasodilatory agent |
| title | Splenic switch-off in regadenoson 82Rb-PET myocardial perfusion imaging: assessment of clinical utility |
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