Shih Yi-San, Wang Shan-Ying, Tzeng Bing-Hsiean, Chuang Wen-Po, Wu Yen-Wen
Department of Nuclear Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Department of Nuclear Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Electrical and Communication Engineering College, Yuan Ze University, Taoyuan City, Taiwan.
J Formos Med Assoc. 2024 Oct 14. doi: 10.1016/j.jfma.2024.10.008.
Background There is a lack of consensus regarding the optimal imaging time points and imaging techniques between planar and/or single-photon emission computed tomography (SPECT)/computed tomography (CT) acquisitions for technetium-99 m pyrophosphate (99mTc-PYP) cardiac scintigraphy. The aim of this study was to investigate correlations between planar and SPECT/CT images and between 1-h and 3-h imaging time points. Methods We retrospectively analyzed consecutive patients with clinically suspected transthyretin amyloid cardiomyopathy who underwent 99mTc-PYP scintigraphy from November 1, 2019 to November 30, 2022. Visual scores were compared between 1- and 3-h imaging time points and between planar and SPECT/CT acquisitions. Results A total of 100 patients (66% male; mean age, 65 years) were included, and 1- and 3-h planar and SPECT/CT images were obtained for 97 patients. There was a significant difference in visual grading scores between 1- and 3-h time points on both planar and SPECT/CT imaging, with a downgrade in score in 61 of 99 (61%) cases on planar imaging, and in 14 of 97 (14%) cases on SPECT/CT imaging (p < 0.001). There were significant differences in visual grading scores between planar and SPECT/CT imaging at both time points, with cases being scored higher on planar imaging than on SPECT/CT imaging (81/97 cases for 1-h imaging, and 50/97 cases for 3-h imaging) (p < 0.001). Conclusion Simplified 1-h SPECT/CT imaging with visual score and selective use of 3-h SPECT/CT imaging may be an efficient protocol and may reduce the potential for over-scoring and equivocal interpretation. Further validation in larger and more diverse populations is needed.
背景 对于锝-99m焦磷酸盐（99mTc-PYP）心肌闪烁显像，在平面和/或单光子发射计算机断层扫描（SPECT）/计算机断层扫描（CT）采集的最佳成像时间点和成像技术方面，目前尚未达成共识。本研究的目的是探讨平面图像与SPECT/CT图像之间以及1小时和3小时成像时间点之间的相关性。方法 我们回顾性分析了2019年11月1日至2022年11月30日期间连续接受99mTc-PYP闪烁显像的临床疑似转甲状腺素蛋白淀粉样心肌病患者。比较了1小时和3小时成像时间点以及平面和SPECT/CT采集之间的视觉评分。结果 共纳入100例患者（男性66%；平均年龄65岁），97例患者获得了1小时和3小时的平面及SPECT/CT图像。在平面和SPECT/CT成像中，1小时和3小时时间点的视觉分级评分均存在显著差异，平面成像中99例（61%）中有61例评分下降，SPECT/CT成像中97例（14%）中有14例评分下降（p<0.001）。在两个时间点，平面和SPECT/CT成像的视觉分级评分均存在显著差异，平面成像的评分高于SPECT/CT成像（1小时成像为81/97例，3小时成像为50/97例）（p<0.001）。结论 采用视觉评分的简化1小时SPECT/CT成像以及选择性使用3小时SPECT/CT成像可能是一种有效的方案，并且可能减少过度评分和模棱两可解释的可能性。需要在更大且更多样化的人群中进行进一步验证。
