Dramé Boubacar, Martz Maximilien, El Ghannudi Soraya, Hubele Fabrice, Hien Mwinbele Stéphane, Bessac Darejan Mamulashvili, Zeyons Floriane, Hunolstein Jean-Jacques Von, Bathily El Hadji Amadou Lamine, Mertz Luc, Blondet Cyrille, Schindler Thomas Helmut, Imperiale Alessio
Nuclear Medicine, Nouvel Hopital Civil, University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France.
Nuclear Medicine, Idrissa Pouye General Hospital (HOGIP), University Cheikh- Anta-Diop (UCAD), Dakar, Sénégal.
Int J Cardiovasc Imaging. 2025 Aug;41(8):1597-1603. doi: 10.1007/s10554-025-03465-z. Epub 2025 Jul 15.
Cardiac function assessment using Tc-DPD ECG-gated SPECT (G-SPECT) in ATTR amyloidosis is underexplored. This study evaluates left ventricular ejection fraction (LVEF) and left ventricular end-diastolic volume (LVEDV) with G-SPECT, comparing results to transthoracic echocardiogram (TTE) and cardiac magnetic resonance imaging (CMR). A regression model obtained comparing G-SPECT and CMR was used to independently predict CMR LVEF from G-SPECT. In this retrospective study, 38 patients with cardiac ATTR amyloidosis (Perugini 2-3) underwent TTE, CMR, and G-SPECT within six months, excluding acute cardiac events or therapeutic changes. G-SPECT were evaluated using QPS-QGS software. A wall-model of polar map presentation was obtained from LV short-axis slices. In the first 30 consecutive patients, mean LVEF was 52.5%±11.3% by TTE, 57.9%±12.4% by CMR, and lower by G-SPECT (42.7%±10.1%, p < 0.001). LVEF from G-SPECT correlated significantly with CMR (r = 0.71, p < 0.001). The regression formula predicting CMR LVEF was: LVEF=0.875 x LVEFG + 20.612. Mean LVEDV was 74.4 ± 21.0 ml/m² by CMR and 61.4 ± 22.9 ml/m² by G-SPECT (p < 0.001), with strong correlation (r = 0.76, p < 0.001). In the last 8 patients, predicted CMR LVEF was comparable to measured CMR LVEF (p = 0.87), with significant correlation (r = 0.73, p = 0.039). This study reveals that Tc-DPD G-SPECT underestimates LVEF and LVEDV compared to CMR, though a consistent correlation was observed between the two modalities. As one of the first structured attempts to explore G-SPECT functional parameters in this setting, our work should be considered a proof of concept, highlighting both the feasibility and the current limitations of this approach. Further studies are needed to refine its accuracy and clarify its place within multimodal clinical imaging strategies.
使用锝-二磷酸脱氧葡萄糖（Tc-DPD）心电图门控单光子发射计算机断层扫描（G-SPECT）评估转甲状腺素蛋白淀粉样变（ATTR）中的心脏功能尚未得到充分研究。本研究使用G-SPECT评估左心室射血分数（LVEF）和左心室舒张末期容积（LVEDV），并将结果与经胸超声心动图（TTE）和心脏磁共振成像（CMR）进行比较。通过比较G-SPECT和CMR得到的回归模型用于从G-SPECT独立预测CMR LVEF。在这项回顾性研究中，38例心脏ATTR淀粉样变患者（佩鲁吉尼2-3级）在6个月内接受了TTE、CMR和G-SPECT检查，排除了急性心脏事件或治疗变化。使用QPS-QGS软件评估G-SPECT。从左心室短轴切片获得极坐标图呈现的壁模型。在前30例连续患者中，TTE测得的平均LVEF为52.5%±11.3%，CMR测得的为57.9%±12.4%，而G-SPECT测得的较低（42.7%±10.1%，p<0.001）。G-SPECT测得的LVEF与CMR显著相关（r=0.71，p<0.001）。预测CMR LVEF的回归公式为：LVEF = 0.875×LVEFG + 20.612。CMR测得的平均LVEDV为74.4±21.0 ml/m²，G-SPECT测得的为61.4±22.9 ml/m²（p<0.001），相关性很强（r=0.76，p<0.001）。在最后8例患者中，预测的CMR LVEF与测得的CMR LVEF相当（p=0.87），相关性显著（r=0.73，p=0.039）。本研究表明，与CMR相比，Tc-DPD G-SPECT低估了LVEF和LVEDV，尽管两种检查方式之间观察到了一致的相关性。作为在这种情况下探索G-SPECT功能参数的首批结构化尝试之一，我们的工作应被视为一个概念验证，突出了这种方法的可行性和当前局限性。需要进一步研究以提高其准确性，并阐明其在多模态临床成像策略中的地位。
