A Quantitative Diagnostic Method Using 99mTc-pyrophosphate Lateral Planar Images to Distinguish Between Transthyretin Amyloid Cardiomyopathy and False-Positive Images Due to Blood Pools
Background: This study investigated the feasibility of using a quantitative diagnostic method based on 99mTc-pyrophosphate scintigraphy (PYP) lateral planar images to differentiate between PYP-positive (myocardial uptake) and false-positive (blood pool uptake) scans. Methods: The study included 93 c...
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| Veröffentlicht in: | Annals of Nuclear Cardiology 2024, Vol.10(1), pp.23-28 |
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| creator | Hara, Junko Ishii, Shiro Kobiyama, Honami Fukushima, Kenji Kawamoto, Natsumi Yamakuni, Ryo Suenaga, Hiroki Muto, Yuuki Sugawara, Shigeyasu Sato, Akihiko Oikawa, Masayoshi Takeishi, Yasuchika Ito, Hiroshi |
| description | Background: This study investigated the feasibility of using a quantitative diagnostic method based on 99mTc-pyrophosphate scintigraphy (PYP) lateral planar images to differentiate between PYP-positive (myocardial uptake) and false-positive (blood pool uptake) scans. Methods: The study included 93 consecutive patients with suspected transthyretin amyloid cardiomyopathy (ATTR-CM) who underwent PYP between April 2022 and December 2023. Patients were categorized using planar anterior PYP images according to the Perugini visual grading system; patients with grades ≥2 were analyzed. Whether the uptake of the ventricle was in the blood pool or the myocardium was confirmed by transaxial single-photon emission tomography (SPECT). The heart-to-mediastinum ratios (H/M ratio) of the left lateral planar images at 1- and 3-h were calculated by placing a circular region of interest in the heart and cephalodorsal side of the heart to determine optimal cut-off values. Results: Among the PYP images, the study analyzed 15 positives diagnosed as ATTR-CM and 10 false positives. Significant differences were observed in the H/M ratio at 1- and 3-h (both p |
| doi_str_mv | 10.17996/anc.24-00001 |
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Methods: The study included 93 consecutive patients with suspected transthyretin amyloid cardiomyopathy (ATTR-CM) who underwent PYP between April 2022 and December 2023. Patients were categorized using planar anterior PYP images according to the Perugini visual grading system; patients with grades ≥2 were analyzed. Whether the uptake of the ventricle was in the blood pool or the myocardium was confirmed by transaxial single-photon emission tomography (SPECT). The heart-to-mediastinum ratios (H/M ratio) of the left lateral planar images at 1- and 3-h were calculated by placing a circular region of interest in the heart and cephalodorsal side of the heart to determine optimal cut-off values. Results: Among the PYP images, the study analyzed 15 positives diagnosed as ATTR-CM and 10 false positives. Significant differences were observed in the H/M ratio at 1- and 3-h (both p <0.01), with 100% sensitivity and specificity using cut-off values of 1.22 and 1.21 at 1- and 3-h, respectively. The interclass correlation coefficients (2, 1) between the two readers were 0.919 and 0.958 for the 1- and 3-h H/M ratios, respectively. Conclusions: Lateral planar PYP imaging can exclude PYP false-positive cases caused by blood pools in a simple and quantitative manner using only a 1-h planar image, possibly obviating the need for SPECT imaging.</description><identifier>ISSN: 2189-3926</identifier><identifier>ISSN: 2424-1741</identifier><identifier>EISSN: 2424-1741</identifier><identifier>DOI: 10.17996/anc.24-00001</identifier><language>eng</language><publisher>Japanese Society of Nuclear Cardiology</publisher><subject>Cardiac amyloidosis ; Lateral scan ; Original ; Planar scintigraphy ; Pyrophosphate ; SPECT ; Transthyretin</subject><ispartof>Annals of Nuclear Cardiology, 2024, Vol.10(1), pp.23-28</ispartof><rights>The Japanese Society of Nuclear Cardiology 2024</rights><rights>The Japanese Society of Nuclear Cardiology 2024.</rights><rights>The Japanese Society of Nuclear Cardiology 2024 2024</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3092-566c64b05cf70c1472aefa9855797388cd6ba5887e7be8d67fb1e030a344a51b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612392/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612392/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,1876,4009,27902,27903,27904,53770,53772</link.rule.ids></links><search><creatorcontrib>Hara, Junko</creatorcontrib><creatorcontrib>Ishii, Shiro</creatorcontrib><creatorcontrib>Kobiyama, Honami</creatorcontrib><creatorcontrib>Fukushima, Kenji</creatorcontrib><creatorcontrib>Kawamoto, Natsumi</creatorcontrib><creatorcontrib>Yamakuni, Ryo</creatorcontrib><creatorcontrib>Suenaga, Hiroki</creatorcontrib><creatorcontrib>Muto, Yuuki</creatorcontrib><creatorcontrib>Sugawara, Shigeyasu</creatorcontrib><creatorcontrib>Sato, Akihiko</creatorcontrib><creatorcontrib>Oikawa, Masayoshi</creatorcontrib><creatorcontrib>Takeishi, Yasuchika</creatorcontrib><creatorcontrib>Ito, Hiroshi</creatorcontrib><title>A Quantitative Diagnostic Method Using 99mTc-pyrophosphate Lateral Planar Images to Distinguish Between Transthyretin Amyloid Cardiomyopathy and False-Positive Images Due to Blood Pools</title><title>Annals of Nuclear Cardiology</title><description>Background: This study investigated the feasibility of using a quantitative diagnostic method based on 99mTc-pyrophosphate scintigraphy (PYP) lateral planar images to differentiate between PYP-positive (myocardial uptake) and false-positive (blood pool uptake) scans. Methods: The study included 93 consecutive patients with suspected transthyretin amyloid cardiomyopathy (ATTR-CM) who underwent PYP between April 2022 and December 2023. Patients were categorized using planar anterior PYP images according to the Perugini visual grading system; patients with grades ≥2 were analyzed. Whether the uptake of the ventricle was in the blood pool or the myocardium was confirmed by transaxial single-photon emission tomography (SPECT). The heart-to-mediastinum ratios (H/M ratio) of the left lateral planar images at 1- and 3-h were calculated by placing a circular region of interest in the heart and cephalodorsal side of the heart to determine optimal cut-off values. Results: Among the PYP images, the study analyzed 15 positives diagnosed as ATTR-CM and 10 false positives. Significant differences were observed in the H/M ratio at 1- and 3-h (both p <0.01), with 100% sensitivity and specificity using cut-off values of 1.22 and 1.21 at 1- and 3-h, respectively. The interclass correlation coefficients (2, 1) between the two readers were 0.919 and 0.958 for the 1- and 3-h H/M ratios, respectively. Conclusions: Lateral planar PYP imaging can exclude PYP false-positive cases caused by blood pools in a simple and quantitative manner using only a 1-h planar image, possibly obviating the need for SPECT imaging.</description><subject>Cardiac amyloidosis</subject><subject>Lateral scan</subject><subject>Original</subject><subject>Planar scintigraphy</subject><subject>Pyrophosphate</subject><subject>SPECT</subject><subject>Transthyretin</subject><issn>2189-3926</issn><issn>2424-1741</issn><issn>2424-1741</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNpVkU1v3CAQhq2qlRqlOfbOsRenxsbYPlW7m6aNtFG30uaMxnhsE9ngAk7kn9Z_V_ajK4XDAHqfeRlmougzTW5pUVX8K2h5m7I4CYu-i65SFi60YPR9ONOyirMq5R-jG-eeA5FSluSMX0V_V-T3DNorD169ILlT0GnjvJLkEX1vGvLklO5IVY17GU-LNVNv3NSDR7INwcJAdgNosORhhA4d8SaYBAPdzcr1ZI3-FVGTvQXtfL9YDBJZjctgVEM2YBtlxsVMEDQCuiH3MDiMd8apY0Fn17sZD87rwYSSdsYM7lP0oT2gN-f9Onq6_77f_Iy3v348bFbbWGZJlcY555KzOsllWySSsiIFbKEq87yoiqwsZcNryMuywKLGsuFFW1NMsgQyxiCndXYdfTv5TnM9YiNR-_BpMVk1gl2EASXeKlr1ojMvglJO09D14PDl7GDNnxmdF6NyEofQNjSzExllPE9pKCKg8QmV1jhnsb28QxNxnLMIcxYpE8c5B3594p-dD3260GDDBAc8wofMQ_ifdBFlD1agzv4BV763hg</recordid><startdate>2024</startdate><enddate>2024</enddate><creator>Hara, Junko</creator><creator>Ishii, Shiro</creator><creator>Kobiyama, Honami</creator><creator>Fukushima, Kenji</creator><creator>Kawamoto, Natsumi</creator><creator>Yamakuni, Ryo</creator><creator>Suenaga, Hiroki</creator><creator>Muto, Yuuki</creator><creator>Sugawara, Shigeyasu</creator><creator>Sato, Akihiko</creator><creator>Oikawa, Masayoshi</creator><creator>Takeishi, Yasuchika</creator><creator>Ito, Hiroshi</creator><general>Japanese Society of Nuclear Cardiology</general><general>The Japanese Society of Nuclear Cardiology</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>2024</creationdate><title>A Quantitative Diagnostic Method Using 99mTc-pyrophosphate Lateral Planar Images to Distinguish Between Transthyretin Amyloid Cardiomyopathy and False-Positive Images Due to Blood Pools</title><author>Hara, Junko ; Ishii, Shiro ; Kobiyama, Honami ; Fukushima, Kenji ; Kawamoto, Natsumi ; Yamakuni, Ryo ; Suenaga, Hiroki ; Muto, Yuuki ; Sugawara, Shigeyasu ; Sato, Akihiko ; Oikawa, Masayoshi ; Takeishi, Yasuchika ; Ito, Hiroshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3092-566c64b05cf70c1472aefa9855797388cd6ba5887e7be8d67fb1e030a344a51b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Cardiac amyloidosis</topic><topic>Lateral scan</topic><topic>Original</topic><topic>Planar scintigraphy</topic><topic>Pyrophosphate</topic><topic>SPECT</topic><topic>Transthyretin</topic><toplevel>online_resources</toplevel><creatorcontrib>Hara, Junko</creatorcontrib><creatorcontrib>Ishii, Shiro</creatorcontrib><creatorcontrib>Kobiyama, Honami</creatorcontrib><creatorcontrib>Fukushima, Kenji</creatorcontrib><creatorcontrib>Kawamoto, Natsumi</creatorcontrib><creatorcontrib>Yamakuni, Ryo</creatorcontrib><creatorcontrib>Suenaga, Hiroki</creatorcontrib><creatorcontrib>Muto, Yuuki</creatorcontrib><creatorcontrib>Sugawara, Shigeyasu</creatorcontrib><creatorcontrib>Sato, Akihiko</creatorcontrib><creatorcontrib>Oikawa, Masayoshi</creatorcontrib><creatorcontrib>Takeishi, Yasuchika</creatorcontrib><creatorcontrib>Ito, Hiroshi</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of Nuclear Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hara, Junko</au><au>Ishii, Shiro</au><au>Kobiyama, Honami</au><au>Fukushima, Kenji</au><au>Kawamoto, Natsumi</au><au>Yamakuni, Ryo</au><au>Suenaga, Hiroki</au><au>Muto, Yuuki</au><au>Sugawara, Shigeyasu</au><au>Sato, Akihiko</au><au>Oikawa, Masayoshi</au><au>Takeishi, Yasuchika</au><au>Ito, Hiroshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Quantitative Diagnostic Method Using 99mTc-pyrophosphate Lateral Planar Images to Distinguish Between Transthyretin Amyloid Cardiomyopathy and False-Positive Images Due to Blood Pools</atitle><jtitle>Annals of Nuclear Cardiology</jtitle><date>2024</date><risdate>2024</risdate><volume>10</volume><issue>1</issue><spage>23</spage><epage>28</epage><pages>23-28</pages><artnum>24-00001</artnum><issn>2189-3926</issn><issn>2424-1741</issn><eissn>2424-1741</eissn><abstract>Background: This study investigated the feasibility of using a quantitative diagnostic method based on 99mTc-pyrophosphate scintigraphy (PYP) lateral planar images to differentiate between PYP-positive (myocardial uptake) and false-positive (blood pool uptake) scans. Methods: The study included 93 consecutive patients with suspected transthyretin amyloid cardiomyopathy (ATTR-CM) who underwent PYP between April 2022 and December 2023. Patients were categorized using planar anterior PYP images according to the Perugini visual grading system; patients with grades ≥2 were analyzed. Whether the uptake of the ventricle was in the blood pool or the myocardium was confirmed by transaxial single-photon emission tomography (SPECT). The heart-to-mediastinum ratios (H/M ratio) of the left lateral planar images at 1- and 3-h were calculated by placing a circular region of interest in the heart and cephalodorsal side of the heart to determine optimal cut-off values. Results: Among the PYP images, the study analyzed 15 positives diagnosed as ATTR-CM and 10 false positives. Significant differences were observed in the H/M ratio at 1- and 3-h (both p <0.01), with 100% sensitivity and specificity using cut-off values of 1.22 and 1.21 at 1- and 3-h, respectively. The interclass correlation coefficients (2, 1) between the two readers were 0.919 and 0.958 for the 1- and 3-h H/M ratios, respectively. Conclusions: Lateral planar PYP imaging can exclude PYP false-positive cases caused by blood pools in a simple and quantitative manner using only a 1-h planar image, possibly obviating the need for SPECT imaging.</abstract><pub>Japanese Society of Nuclear Cardiology</pub><doi>10.17996/anc.24-00001</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Cardiac amyloidosis Lateral scan Original Planar scintigraphy Pyrophosphate SPECT Transthyretin |
| title | A Quantitative Diagnostic Method Using 99mTc-pyrophosphate Lateral Planar Images to Distinguish Between Transthyretin Amyloid Cardiomyopathy and False-Positive Images Due to Blood Pools |
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