Zhang Xue, Nakajima Kenichi, Acampa Wanda, Assante Roberta, D'Antonio Adriana, Okuda Koichi, Yokoyama Kunihiko, Kinuya Seigo
Department of Nuclear Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8640, Japan.
Department of Functional Imaging and Artificial Intelligence, Kanazawa University, Kanazawa, Japan.
Ann Nucl Med. 2025 Jun 2. doi: 10.1007/s12149-025-02061-4.
We aimed to develop I-meta-iodobenzylguanidine (MIBG) normal databases (NDBs) for D-SPECT that included Japanese and European populations and to validate the ability of combined NDBs to diagnose heart failure (HF).
This study included 55 Japanese and 33 Italian patients without cardiac or neurological diseases associated with Lewy bodies. Single-photon emission computed tomography (SPECT) images were acquired 20 min and 3-4 h after I-MIBG injection. We established NDBs for Japanese (Jp-NDB) and Italian (It-NDB) patients, and combined them (JpIt-NDB) using 17-segment polar maps. We also compared the Jp- with the Anger camera NDB established by the Japanese Society of Nuclear Medicine and clinically validated our findings in a cohort of 31 patients with HF.
The average uptake in the anterior segments was lower in the It-NDB and differences were more pronounced in males. The JpIt-NDB closely aligned with both the Jp-NDB and It-NDB. Clinical validation indicated that HF was identified more accurately by automated defect scores derived from the JpIt-NDB than visual scores (area under the receiver operating characteristic (ROC) curve (AUC): 0.827 vs. 0.683; P = 0.032). Combining JpIt-NDB-derived scores based on the heart-to-mediastinum ratio (HMR) significantly enhanced diagnostic accuracy (early and late AUCs: 0.960 and 0.952, respectively).
The combined JpIt-NDB accurately diagnosed HF in Japanese and European patients, while the defect scores correlated closely to Jp- and It-NDBs. Integrated HMR and NDB defect scores significantly enhanced cardiac assessment precision, which offers promise for future investigations into cardiac innervation imaging.
我们旨在为双探头单光子发射计算机断层扫描（D-SPECT）开发包含日本人和欧洲人群的碘-间位碘代苄胍（MIBG）正常数据库（NDBs），并验证联合NDBs诊断心力衰竭（HF）的能力。
本研究纳入了55名无与路易体相关的心脏或神经疾病的日本患者和33名意大利患者。在注射I-MIBG后20分钟和3 - 4小时采集单光子发射计算机断层扫描（SPECT）图像。我们为日本患者（Jp-NDB）和意大利患者（It-NDB）建立了NDBs，并使用17节段极坐标图将它们合并（JpIt-NDB）。我们还将Jp-NDB与日本核医学协会建立的安格相机NDB进行了比较，并在31名HF患者队列中对我们的发现进行了临床验证。
It-NDB中前壁节段的平均摄取较低，且在男性中差异更明显。JpIt-NDB与Jp-NDB和It-NDB都紧密对齐。临床验证表明，与视觉评分相比，由JpIt-NDB得出的自动缺损评分能更准确地识别HF（受试者操作特征曲线（ROC）下面积（AUC）：0.827对0.683；P = 0.032）。基于心纵隔比（HMR）合并JpIt-NDB得出的评分显著提高了诊断准确性（早期和晚期AUC分别为0.960和0.952）。
联合的JpIt-NDB能准确诊断日本和欧洲患者的HF，而缺损评分与Jp-NDB和It-NDB密切相关。综合HMR和NDB缺损评分显著提高了心脏评估的精度，这为未来心脏神经支配成像研究带来了希望。
