Revista espanola de medicina nuclear e imagen molecular · 2023
Absolute quantification of myocardial uptake of 99mTc-DPD in patients with cardiac amyloidosis due to transthyretin deposits (ATTR).
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Sebastián Palacid Francisco, Álvarez Mena Noelia, Del Carmen Zambrano Infantino Rosanna, García Aragón María, Alonso Rodríguez Mercedes, Pérez López Berta, Gamazo Laherrán Claudia, González Soto María Jesús, Ruano Pérez Ricardo
Аннотация
PURPOSE: To determine the diagnostic contribution of the absolute quantification of the myocardial deposit of 99mTc-DPD in patients with cardiac amyloidosis due to transthyretin deposits (ATTR).
MATERIALS AND METHODS: SPECT/CT was performed in 41 patients with positive scintigraphic results for ATTR cardiac amyloidosis. The patients were divided into two groups (Perugini grades 2 and 3) and the SUVmax at the level of the bone and both ventricles and the percentage of dose calculated in these areas were calculated. The Student's t-test was used to compare results and the area under the curve (AUC) was calculated to assess differential efficacy and establish discriminatory cut-off points between both groups of patients.
RESULTS: Statistically significant differences were observed in all the study variables, with the exception of bone SUVmax. The differences with the greatest statistical power were observed in the variables SUVmaxRV and the percentage of dose in both ventricles (p < 0.001). The cut-off point obtained for the variable SUVmaxLV was 8.620 (sensitivity 87.9% and specificity 100%; AUC 0.966), while that of the variable SUVmaxRV was 6.195 (sensitivity 81.8% and specificity 100%; AUC 0.955).
CONCLUSIONS: The absolute quantification of myocardial uptake of 99mTc-DPD in the SPECT/CT images of patients with suspected cardiac amyloidosis due to transthyretin deposits represents a new diagnostic tool that allows adequate classification of patients according to the Perugini visual grading scale.
MATERIALS AND METHODS: SPECT/CT was performed in 41 patients with positive scintigraphic results for ATTR cardiac amyloidosis. The patients were divided into two groups (Perugini grades 2 and 3) and the SUVmax at the level of the bone and both ventricles and the percentage of dose calculated in these areas were calculated. The Student's t-test was used to compare results and the area under the curve (AUC) was calculated to assess differential efficacy and establish discriminatory cut-off points between both groups of patients.
RESULTS: Statistically significant differences were observed in all the study variables, with the exception of bone SUVmax. The differences with the greatest statistical power were observed in the variables SUVmaxRV and the percentage of dose in both ventricles (p < 0.001). The cut-off point obtained for the variable SUVmaxLV was 8.620 (sensitivity 87.9% and specificity 100%; AUC 0.966), while that of the variable SUVmaxRV was 6.195 (sensitivity 81.8% and specificity 100%; AUC 0.955).
CONCLUSIONS: The absolute quantification of myocardial uptake of 99mTc-DPD in the SPECT/CT images of patients with suspected cardiac amyloidosis due to transthyretin deposits represents a new diagnostic tool that allows adequate classification of patients according to the Perugini visual grading scale.