Examining the sensitivity of 18F-NaF PET for the imaging of cardiac amyloidosis

Martineau, Patrick; Finnerty, Vincent; Giraldeau, Geneviève; Authier, Sébastien; Harel, François; Pelletier‐Galarneau, Matthieu

doi:10.1007/s12350-019-01675-2

Cited by 42 publications

(27 citation statements)

References 21 publications

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“…Our findings are in keeping with our own and recently published work by other groups. 17,23,24 The diagnosis and treatment of cardiac amyloidosis has advanced markedly over the last 10 years. AL amyloid can now be treated with disease modifying novel chemotherapeutic agents 25,26 , while contemporary TTR therapies target suppression of TTR expression and stabilization of transthyretin, improving patients outcomes.…”

Section: Discussionmentioning

confidence: 99%

18F-fluoride PET/MR in cardiac amyloid: A comparison study with aortic stenosis and age- and sex-matched controls

Andrews

Trivieri

Everett

et al. 2022

Journal of Nuclear Cardiology

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Objectives Cardiac MR is widely used to diagnose cardiac amyloid, but cannot differentiate AL and ATTR subtypes: an important distinction given their differing treatments and prognoses. We used PET/MR imaging to quantify myocardial uptake of 18F-fluoride in ATTR and AL amyloid patients, as well as participants with aortic stenosis and age/sex-matched controls. Methods In this prospective multicenter study, patients were recruited in Edinburgh and New York and underwent 18F-fluoride PET/MR imaging. Standardized volumes of interest were drawn in the septum and areas of late gadolinium enhancement to derive myocardial standardized uptake values (SUV) and tissue-to-background ratio (TBRMEAN) after correction for blood pool activity in the right atrium. Results 53 patients were scanned: 18 with cardiac amyloid (10 ATTR and 8 AL), 13 controls, and 22 with aortic stenosis. No differences in myocardial TBR values were observed between participants scanned in Edinburgh and New York. Mean myocardial TBRMEAN values in ATTR amyloid (1.13 ± 0.16) were higher than controls (0.84 ± 0.11, P = .0006), aortic stenosis (0.73 ± 0.12, P < .0001), and those with AL amyloid (0.96 ± 0.08, P = .01). TBRMEAN values within areas of late gadolinium enhancement provided discrimination between patients with ATTR (1.36 ± 0.23) and all other groups (e.g., AL [1.06 ± 0.07, P = .003]). A TBRMEAN threshold >1.14 in areas of LGE demonstrated 100% sensitivity (CI 72.25 to 100%) and 100% specificity (CI 67.56 to 100%) for ATTR compared to AL amyloid (AUC 1, P = .0004). Conclusion Quantitative 18F-fluoride PET/MR imaging can distinguish ATTR amyloid from other similar phenotypes and holds promise in improving the diagnosis of this condition.

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Section: Discussionmentioning

confidence: 99%

18F-fluoride PET/MR in cardiac amyloid: A comparison study with aortic stenosis and age- and sex-matched controls

Andrews

Trivieri

Everett

et al. 2022

Journal of Nuclear Cardiology

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“…Recently quantitative PET with bone scan agent, 18 Fluorine-labeled sodium uoride ( 18 F-NaF) was evaluated for the diagnosis of ATTR-CM, but not quite promising [34]. Quantitative PET with β-amyloid speci c imaging tracers such as 18 F-Florbetapir, 18 F-Flutemetamol and 11 C-PIB enabled the quantitative scheme to evaluate cardiac ATTR amyloidosis [14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Assessment of Cardiac Amyloidosis with 99mTc-Pyrophosphate (PYP) Quantitative SPECT

Ren

Tian

et al. 2020

Preprint

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Background: 99mTc-PYP scintigraphy provides differential diagnosis of ATTR cardiomyopathy (ATTR-CM) from light chain cardiac amyloidosis and other myocardial disorders without biopsy. This study was aimed to assess the diagnostic feasibility and the operator reproducibility of 99mTc-PYP quantitative SPECT.Method: Thirty-seven consecutive patients underwent a 99mTc-PYP thorax planar scan followed by SPECT and CT scans to diagnose suspected ATTR-CM were enrolled. For the quantitative SPECT, phantom studies were initially performed to determine the image conversion factor (ICF) and partial volume correction (PVC) factor to recover 99mTc-PYP activity concentration in myocardium for calculating the standardized uptake value (SUV) (unit: g/ml). SUVmax was compared among groups of ATTR-CM, AL cardiac amyloidosis and other pathogens (Others), and among categories of Perugini visual scores (Grade: 0-3). The intra- and inter-operator reproducibility of quantitative SPECT was verified, and the corresponded repeatability coefficient (RPC) was calculated.Results: The ICF was 79,327 Bq/ml to convert count rate in pixel to 99mTc activity concentration. PVC factor as a function of the measured activity concentration ratio in myocardium and blood-pool was [y=1.424*(1-exp(-0.759*x)) +0.104]. SUVmax of ATTR-CM (7.50±2.68) was significantly higher than those of AL (1.96±0.35) and Others (2.00±0.74) (all p<0.05). SUVmax of Grade 3 (8.95±1.89) and Grade 2 (4.71±0.23) were also significantly higher than those of Grade 1 (1.92±0.31) and Grade 0 (1.59±0.39) (all p <0.05). Correlation coefficient (R2) of SUVmax reached 0.966 to 0.978 with only small systematic difference (intra=-0.14; inter=-0.23) between two repeated measurements. Intra- and inter-operator RPCs were 0.688 and 0.877.Conclusions: 99mTc-PYP quantitative SPECT integrated with adjustable PVC factors is feasible to quantitatively and objectively assess the burden of cardiac amyloidosis for diagnosis of ATTR-CM.

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“…This exceptional difference may provoke an additional value in prognosis for high grade of ATTR-CM using 99m Tc-PYP quantitative SPECT. Recently quantitative PET with bone scan agent, 18 Fluorine-labeled sodium uoride ( 18 F-NaF) was evaluated for the diagnosis of ATTR-CM, but its performance was not promising [34]. Quantitative PET with β-amyloid speci c imaging tracers such as 18 F-Florbetapir, 18 F-Flutemetamol and 11 C-PIB enabled the quantitative scheme to evaluate cardiac ATTR amyloidosis [14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Assessment of Cardiac Amyloidosis with 99mTc-Pyrophosphate (PYP) Quantitative SPECT

Ren

Tian

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: 99mTc-PYP scintigraphy provides differential diagnosis of ATTR cardiomyopathy (ATTR-CM) from light chain cardiac amyloidosis and other myocardial disorders without biopsy. This study was aimed to assess the diagnostic feasibility and the operator reproducibility of 99mTc-PYP quantitative SPECT. Method: Thirty-seven consecutive patients underwent a 99mTc-PYP thorax planar scan followed by SPECT and CT scans to diagnose suspected ATTR-CM were enrolled. For the quantitative SPECT, phantom studies were initially performed to determine the image conversion factor (ICF) and partial volume correction (PVC) factor to recover 99mTc-PYP activity concentration in myocardium for calculating the standardized uptake value (SUV) (unit: g/ml). SUVmax was compared among groups of ATTR-CM, AL cardiac amyloidosis and other pathogens (Others), and among categories of Perugini visual scores (Grade: 0-3). The intra- and inter-operator reproducibility of quantitative SPECT was verified, and the corresponded repeatability coefficient (RPC) was calculated. Results: The ICF was 79,327 Bq/ml to convert count rate in pixel to 99mTc activity concentration. PVC factor as a function of the measured activity concentration ratio in myocardium and blood-pool was [y=1.424*(1-exp(-0.759*x)) +0.104]. SUVmax of ATTR-CM (7.50±2.68) was significantly higher than those of AL (1.96±0.35) and Others (2.00±0.74) (all p<0.05). SUVmax of Grade 3 (8.95±1.89) and Grade 2 (4.71±0.23) were also significantly higher than those of Grade 1 (1.92±0.31) and Grade 0 (1.59±0.39) (all p <0.05). Correlation coefficient (R2) of SUVmax reached 0.966 to 0.978 with only small systematic difference (intra=-0.14; inter=-0.23) between two repeated measurements. Intra- and inter-operator RPCs were 0.688 and 0.877.Conclusions: 99mTc-PYP quantitative SPECT is feasible to quantitatively and objectively assess the burden of cardiac amyloidosis for diagnosis of ATTR-CM.

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Examining the sensitivity of 18F-NaF PET for the imaging of cardiac amyloidosis

Cited by 42 publications

References 21 publications

18F-fluoride PET/MR in cardiac amyloid: A comparison study with aortic stenosis and age- and sex-matched controls

18F-fluoride PET/MR in cardiac amyloid: A comparison study with aortic stenosis and age- and sex-matched controls

Assessment of Cardiac Amyloidosis with 99mTc-Pyrophosphate (PYP) Quantitative SPECT

Assessment of Cardiac Amyloidosis with 99mTc-Pyrophosphate (PYP) Quantitative SPECT

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