Utility of the Method for Calculating the Heart to Contralateral Ratio for Cardiac Amyloidosis by Using Ray-summation Images in 99mTc-pyrophosphate Scintigraphy
Purpose: The purpose of this study was to avoid the influence of background activity in the calculation of heart to contralateral ratio (H/CL) in 99mTc-pyrophosphate (PYP) scintigraphy for diagnosis of cardiac amyloidosis. Therefore, we investigated the utility of the H/CL calculation method using r...
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| Published in | Japanese Journal of Radiological Technology Vol. 78; no. 12; pp. 1399 - 1405 |
|---|---|
| Main Authors | , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Kyoto
Japanese Society of Radiological Technology
01.01.2022
Japan Science and Technology Agency |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0369-4305 1881-4883 |
| DOI | 10.6009/jjrt.2022-1297 |
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| Abstract | Purpose: The purpose of this study was to avoid the influence of background activity in the calculation of heart to contralateral ratio (H/CL) in 99mTc-pyrophosphate (PYP) scintigraphy for diagnosis of cardiac amyloidosis. Therefore, we investigated the utility of the H/CL calculation method using ray-summation (ray-sum) images created by multi-planar reconstruction and summing slices of the heart range from single-photon emission computed tomography (SPECT) images. Methods: The subjects were 33 patients who underwent 99mTc-PYP planar and SPECT/CT at 3 hours after injection. Ray-summation axial (ray-sum axial) and ray-summation coronal (ray-sum coronal) images were created and H/CL was calculated. We compared the differences in sensitivity, specificity, accuracy, and area under the curve (AUC) between the conventional method and our method, and calculated the cutoff values. Results: Comparison of the conventional method and our method showed no significant difference in sensitivity and AUC, while specificity was significantly improved to 97% (p=0.003) of ray-sum axial image and 90% (p=0.01) of ray-sum coronal image, and accuracy was significantly improved to 94% (p=0.02) of ray-sum axial image. Conclusion: The H/CL calculation method using ray-sum images had higher diagnostic performance than the conventional method, with optimal cutoff of ray-sum axial images 3.07 and ray-sum coronal images 2.77. |
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| AbstractList | Purpose: The purpose of this study was to avoid the influence of background activity in the calculation of heart to contralateral ratio (H/CL) in 99mTc-pyrophosphate (PYP) scintigraphy for diagnosis of cardiac amyloidosis. Therefore, we investigated the utility of the H/CL calculation method using ray-summation (ray-sum) images created by multi-planar reconstruction and summing slices of the heart range from single-photon emission computed tomography (SPECT) images. Methods: The subjects were 33 patients who underwent 99mTc-PYP planar and SPECT/CT at 3 hours after injection. Ray-summation axial (ray-sum axial) and ray-summation coronal (ray-sum coronal) images were created and H/CL was calculated. We compared the differences in sensitivity, specificity, accuracy, and area under the curve (AUC) between the conventional method and our method, and calculated the cutoff values. Results: Comparison of the conventional method and our method showed no significant difference in sensitivity and AUC, while specificity was significantly improved to 97% (p=0.003) of ray-sum axial image and 90% (p=0.01) of ray-sum coronal image, and accuracy was significantly improved to 94% (p=0.02) of ray-sum axial image. Conclusion: The H/CL calculation method using ray-sum images had higher diagnostic performance than the conventional method, with optimal cutoff of ray-sum axial images 3.07 and ray-sum coronal images 2.77. |
| ArticleNumber | 2022-1297 |
| Author | Takata, Kei Horita, Hirokazu Shibutani, Naoki |
| Author_xml | – sequence: 1 fullname: Takata, Kei organization: Department of Radiology, Toyama University Hospital – sequence: 1 fullname: Horita, Hirokazu organization: Department of Radiology, Toyama University Hospital – sequence: 1 fullname: Shibutani, Naoki organization: Department of Radiology, Toyama University Hospital |
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| Cites_doi | 10.1161/CIRCULATIONAHA.116.021612 10.1007/s12350-020-02081-9 10.1038/bmt.2012.244 10.1001/jamacardio.2016.2839 10.1186/s40658-020-00342-7 10.1016/j.jacc.2005.05.073 10.1161/CIRCIMAGING.113.000178 10.1007/s12350-021-02857-7 10.1007/s12350-020-02328-5 10.1007/s12350-020-02205-1 10.2967/jnumed.120.247312 10.1161/CIRCIMAGING.112.000132 10.1007/s12350-019-01760-6 10.1007/s12350-019-01935-1 10.1161/CIRCIMAGING.119.010249 10.1007/s12350-020-02139-8 |
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| References | 5） Perugini E, Guidalotti PL, Salvi F, et al. Noninvasive etiologic diagnosis of cardiac amyloidosis using 99mTc-3, 3-diphosphono-1, 2-propanodicarboxylic acid scintigraphy. J Am Coll Cardiol 2005; 46(6): 1076–1084. 7） Dorbala S, Ando Y, Bokhari S, et al. ASNC/AHA/ASE/EANM/HFSA/ISA/SCMR/SNMMI expert consensus recommendations for multimodality imaging in cardiac amyloidosis: part 1 of 2–evidence base and standardized methods of imaging. J Nucl Cardiol 2019; 26(6): 2065–2123. 16） 竹内鉄夫．骨スキャニング用99mTc標識リン酸系化合物の生体内分布と骨集積機序の研究．金沢大十全医会誌 1979; 88(6): 849–866. 3） Ruberg FL, Miller EJ. Nuclear tracers for transthyretin cardiac amyloidosis: time to bone up? Circ Cardiovasc Imaging 2013; 6(2): 162–164. 10） Ren C, Ren J, Tian Z, et al. Assessment of cardiac amyloidosis with 99mTc-pyrophosphate (PYP) quantitative SPECT. EJNMMI Phys 2021; 8(1): 3. 11） Watanabe S, Nakajima K, Wakabayashi H, et al. Volumetric evaluation of 99mTc-pyrophosphate SPECT/CT for transthyretin cardiac amyloidosis: methodology and correlation with cardiac functional parameters. J Nucl Cardiol 2021; Epub ahead of print. 2） Castano A, Haq M, Narotsky DL, et al. Multicenter study of planar technetium 99m pyrophosphate cardiac imaging: predicting survival for patients with ATTR cardiac amyloidosis. JAMA Cardiol 2016; 1(8): 880–889. 19） Masri A, Bukhari S, Ahmad S, et al. Efficient 1-hour technetium-99m pyrophosphate imaging protocol for the diagnosis of transthyretin cardiac amyloidosis. Circ Cardiovasc Imaging 2020; 13(2): e010249. 1） Gillmore JD, Maurer MS, Falk RH, et al. Nonbiopsy diagnosis of cardiac transthyretin amyloidosis. Circulation 2016; 133(24): 2404–2412. 6） Bokhari S, Castaño A, Pozniakoff T, et al. 99mTc-pyrophosphate scintigraphy for differentiating light-chain cardiac amyloidosis from the transthyretin-related familial and senile cardiac amyloidoses. Circ Cardiovasc Imaging 2013; 6(2): 195–201. 9） Ramsay SC, Cuscaden C. The current status of quantitative SPECT/CT in the assessment of transthyretin cardiac amyloidosis. J Nucl Cardiol 2020; 27(5): 1464–1468. 15） 市川佳誉，泉家康宏．マルチモダリティイメージングで心アミロイドーシスを診断する．医のあゆみ 2020; 275(6): 715–720. 12） Dorbala S, Park MA, Cuddy S, et al. Absolute quantitation of cardiac 99mTc-pyrophosphate using cadmium-Zinc-telluride–based SPECT/CT. J Nucl Med 2021; 62(5): 716–722. 13） Shibutani T, Nakajima K, Yoneyama H, et al. The utility of heart-to-mediastinum ratio using a planar image created from IQ-SPECT with Iodine-123 meta-iodobenzylguanidine. J Nucl Cardiol 2021; 28(6): 2569–2577. 18） Castano A, Haq M, Narotsky DL, et al. Multicenter study of planar technetium 99m pyrophosphate cardiac imaging: predicting survival for patients with ATTR cardiac amyloidosis. JAMA Cardiol 2016; 1(8): 880–889. 14） Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant 2013; 48(3): 452–458. 8） Régis C, Harel F, Martineau P, et al. Tc-99m-pyrophosphate scintigraphy for the diagnosis of ATTR cardiac amyloidosis: comparison of quantitative and semi-quantitative approaches. J Nucl Cardiol 2020; 27(5): 1808–1815. 17） Asif T, Gomez J, Singh V, et al. Comparison of planar with tomographic pyrophosphate scintigraphy for transthyretin cardiac amyloidosis: perils and pitfalls. J Nucl Cardiol 2021; 28(1): 104–111. 20） Sperry BW, Burgett E, Bybee KA, et al. Technetium pyrophosphate nuclear scintigraphy for cardiac amyloidosis: imaging at 1 vs 3 hours and planar vs SPECT/CT. J Nucl Cardiol 2020; 27(5): 1802–1807. 4） 日本循環器学会，日本アミロイドーシス学会，日本血液学会，他．2020年版心アミロイドーシス診療ガイドライン．2020. https://www.j-circ.or.jp/cms/wp-content/uploads/2020/02/JCS2020_Kitaoka.pdf（2022年4月8日アクセス）. 11 12 13 14 15 16 17 18 19 1 2 3 4 5 6 7 8 9 20 10 |
| References_xml | – reference: 10） Ren C, Ren J, Tian Z, et al. Assessment of cardiac amyloidosis with 99mTc-pyrophosphate (PYP) quantitative SPECT. EJNMMI Phys 2021; 8(1): 3. – reference: 17） Asif T, Gomez J, Singh V, et al. Comparison of planar with tomographic pyrophosphate scintigraphy for transthyretin cardiac amyloidosis: perils and pitfalls. J Nucl Cardiol 2021; 28(1): 104–111. – reference: 18） Castano A, Haq M, Narotsky DL, et al. Multicenter study of planar technetium 99m pyrophosphate cardiac imaging: predicting survival for patients with ATTR cardiac amyloidosis. JAMA Cardiol 2016; 1(8): 880–889. – reference: 3） Ruberg FL, Miller EJ. Nuclear tracers for transthyretin cardiac amyloidosis: time to bone up? Circ Cardiovasc Imaging 2013; 6(2): 162–164. – reference: 6） Bokhari S, Castaño A, Pozniakoff T, et al. 99mTc-pyrophosphate scintigraphy for differentiating light-chain cardiac amyloidosis from the transthyretin-related familial and senile cardiac amyloidoses. Circ Cardiovasc Imaging 2013; 6(2): 195–201. – reference: 13） Shibutani T, Nakajima K, Yoneyama H, et al. The utility of heart-to-mediastinum ratio using a planar image created from IQ-SPECT with Iodine-123 meta-iodobenzylguanidine. J Nucl Cardiol 2021; 28(6): 2569–2577. – reference: 9） Ramsay SC, Cuscaden C. The current status of quantitative SPECT/CT in the assessment of transthyretin cardiac amyloidosis. J Nucl Cardiol 2020; 27(5): 1464–1468. – reference: 5） Perugini E, Guidalotti PL, Salvi F, et al. Noninvasive etiologic diagnosis of cardiac amyloidosis using 99mTc-3, 3-diphosphono-1, 2-propanodicarboxylic acid scintigraphy. J Am Coll Cardiol 2005; 46(6): 1076–1084. – reference: 16） 竹内鉄夫．骨スキャニング用99mTc標識リン酸系化合物の生体内分布と骨集積機序の研究．金沢大十全医会誌 1979; 88(6): 849–866. – reference: 12） Dorbala S, Park MA, Cuddy S, et al. Absolute quantitation of cardiac 99mTc-pyrophosphate using cadmium-Zinc-telluride–based SPECT/CT. J Nucl Med 2021; 62(5): 716–722. – reference: 14） Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant 2013; 48(3): 452–458. – reference: 7） Dorbala S, Ando Y, Bokhari S, et al. ASNC/AHA/ASE/EANM/HFSA/ISA/SCMR/SNMMI expert consensus recommendations for multimodality imaging in cardiac amyloidosis: part 1 of 2–evidence base and standardized methods of imaging. J Nucl Cardiol 2019; 26(6): 2065–2123. – reference: 11） Watanabe S, Nakajima K, Wakabayashi H, et al. Volumetric evaluation of 99mTc-pyrophosphate SPECT/CT for transthyretin cardiac amyloidosis: methodology and correlation with cardiac functional parameters. J Nucl Cardiol 2021; Epub ahead of print. – reference: 4） 日本循環器学会，日本アミロイドーシス学会，日本血液学会，他．2020年版心アミロイドーシス診療ガイドライン．2020. https://www.j-circ.or.jp/cms/wp-content/uploads/2020/02/JCS2020_Kitaoka.pdf（2022年4月8日アクセス）. – reference: 20） Sperry BW, Burgett E, Bybee KA, et al. Technetium pyrophosphate nuclear scintigraphy for cardiac amyloidosis: imaging at 1 vs 3 hours and planar vs SPECT/CT. J Nucl Cardiol 2020; 27(5): 1802–1807. – reference: 8） Régis C, Harel F, Martineau P, et al. Tc-99m-pyrophosphate scintigraphy for the diagnosis of ATTR cardiac amyloidosis: comparison of quantitative and semi-quantitative approaches. J Nucl Cardiol 2020; 27(5): 1808–1815. – reference: 1） Gillmore JD, Maurer MS, Falk RH, et al. Nonbiopsy diagnosis of cardiac transthyretin amyloidosis. Circulation 2016; 133(24): 2404–2412. – reference: 2） Castano A, Haq M, Narotsky DL, et al. Multicenter study of planar technetium 99m pyrophosphate cardiac imaging: predicting survival for patients with ATTR cardiac amyloidosis. JAMA Cardiol 2016; 1(8): 880–889. – reference: 15） 市川佳誉，泉家康宏．マルチモダリティイメージングで心アミロイドーシスを診断する．医のあゆみ 2020; 275(6): 715–720. – reference: 19） Masri A, Bukhari S, Ahmad S, et al. Efficient 1-hour technetium-99m pyrophosphate imaging protocol for the diagnosis of transthyretin cardiac amyloidosis. Circ Cardiovasc Imaging 2020; 13(2): e010249. – ident: 1 doi: 10.1161/CIRCULATIONAHA.116.021612 – ident: 13 doi: 10.1007/s12350-020-02081-9 – ident: 14 doi: 10.1038/bmt.2012.244 – ident: 2 doi: 10.1001/jamacardio.2016.2839 – ident: 4 – ident: 10 doi: 10.1186/s40658-020-00342-7 – ident: 5 doi: 10.1016/j.jacc.2005.05.073 – ident: 3 doi: 10.1161/CIRCIMAGING.113.000178 – ident: 11 doi: 10.1007/s12350-021-02857-7 – ident: 17 doi: 10.1007/s12350-020-02328-5 – ident: 8 doi: 10.1007/s12350-020-02205-1 – ident: 16 – ident: 12 doi: 10.2967/jnumed.120.247312 – ident: 15 – ident: 18 doi: 10.1001/jamacardio.2016.2839 – ident: 6 doi: 10.1161/CIRCIMAGING.112.000132 – ident: 7 doi: 10.1007/s12350-019-01760-6 – ident: 9 doi: 10.1007/s12350-019-01935-1 – ident: 19 doi: 10.1161/CIRCIMAGING.119.010249 – ident: 20 doi: 10.1007/s12350-020-02139-8 |
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| SubjectTerms | 99mTc-pyrophosphate scintigraphy Amyloidosis cardiac amyloidosis Computed tomography Heart Mathematical analysis Medical imaging Photon emission Scintigraphy Sensitivity Single photon emission computed tomography single-photon emission computed tomography (SPECT) |
| Title | Utility of the Method for Calculating the Heart to Contralateral Ratio for Cardiac Amyloidosis by Using Ray-summation Images in 99mTc-pyrophosphate Scintigraphy |
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