Mallón Araujo María Del Carmen, Abou Jokh Casas Estephany, Abou Jokh Casas Charigan, Aguade Bruix Santiago, Ruibal Morell Álvaro, Pubul Núñez Virginia
Nuclear Medicine Physician, University of Santiago de Compostela, 15703 Spain.
Nuclear medicine Department, Lucus Augusti University Hospital, úa Dr. Ulises Romero, 1, 27003 Lugo, Spain.
Rev Esp Med Nucl Imagen Mol (Engl Ed). 2023 May-Jun;42(3):171-177. doi: 10.1016/j.remnie.2023.02.005. Epub 2023 Feb 14.
Bone tracers such as Tc-DPD have shown high sensitivity and specificity in the non-invasive diagnosis of transthyretin cardiac amyloidosis (ATTR-CA). This study aims to validate SPECT/CT and assess the usefulness of uptake quantification (DPDload) in the myocardial tissue as potential information on the amyloid burden.
In a retrospective analysis of 46 patients with suspected CA, 23 cases with ATTR-CA had two quantification methods conducted to estimate amyloid burden (DPDload) through planar scintigraphic scans and a SPECT/CT.
SPECT/CT significantly provided an added value in the patient's diagnosis with CA (P<.05). The estimation of the amyloid burden substantiated that the most affected wall of the LV is the interventricular septum in most cases and the existence of a significant relationship between the Perugini score uptake and the DPDload.
We validate the need for SPECT/CT to complement planar imaging in diagnosing ATTR-CA. For its part, quantifying the amyloid load continues to be a complex area of research. It requires further studies with a larger number of patients to validate a standardized method of amyloid load quantification, both for diagnosis and treatment monitoring.
诸如锝-二膦酸盐(Tc-DPD)等骨显像剂在转甲状腺素蛋白心脏淀粉样变性(ATTR-CA)的无创诊断中已显示出高敏感性和特异性。本研究旨在验证单光子发射计算机断层扫描/计算机断层扫描(SPECT/CT)并评估心肌组织中摄取定量(DPD负荷)作为淀粉样蛋白负荷潜在信息的有用性。
在对46例疑似心脏淀粉样变性(CA)患者的回顾性分析中,对23例ATTR-CA患者采用两种定量方法,通过平面闪烁扫描和SPECT/CT来估计淀粉样蛋白负荷(DPD负荷)。
SPECT/CT在CA患者的诊断中显著提供了附加价值(P<0.05)。淀粉样蛋白负荷的估计证实,在大多数情况下,左心室受影响最严重的壁是室间隔,并且佩鲁吉尼评分摄取与DPD负荷之间存在显著关系。
我们验证了在诊断ATTR-CA时需要SPECT/CT来补充平面成像。就其本身而言,量化淀粉样蛋白负荷仍然是一个复杂的研究领域。需要对更多患者进行进一步研究,以验证用于诊断和治疗监测的标准化淀粉样蛋白负荷量化方法。