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Quantitation of myocardial 99mTc-HMDP uptake with new SPECT/CT cadmium zinc telluride (CZT) camera in patients with transthyretin-related cardiac amyloidosis: Ready for clinical use?

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

The aim of this study was to investigate the feasibility of assessing absolute myocardial 99mTc-HMDP uptake in patients with suspected cardiac ATTR using SUV with a whole-body CZT SPECT-CT camera (DNM670CZT).

Methods

Fifteen patients with suspected cardiac ATTR (Perugini ≥ 2) underwent a conventional 99mTc-HMDP planar imaging and a thoracic SPECT/CT using a DNM 670CZT. A control group consisted of 15 patients with negative scintigraphy (Perugini < 2). SUVmax (mg·L−1) and percentage of injected dose (%ID) were calculated in a cardiac volume of interest (VOI) encompassing the left ventricle. VOIs were also placed in the lung, the right pectoris major, and the sternum. A heart-to-lung SUVmax ratio (HLR) was calculated.

Results

All ATTR patients demonstrated an increased cardiac HMDP SUVmax (12.2 ± 3.7 mg·L−1) vs controls (3.5 ± 1.2, P < .0001). Percentage of ID, pectoral uptake and HLR were significantly higher in the ATTR group (1.1 ± 0.3 vs 0.15 ± 0.8, P < .0001; 1.5 ± 0.3 vs 0.9 ± 0.3, P < .0001; 9.7 ± 3 vs 4.3 ± 2.2, P < .0001). Bone uptake was not statistically different between the two groups.

Conclusion

This study demonstrated the feasibility of quantitative 99mTc-HMDP SUVmax measurement using a whole-body SPECT/CT CZT camera in patients with suspected cardiac ATTR.

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Abbreviations

ATTR:

Transthyretin-related amyloidosis

CZT:

Cadmium zinc telluride

SPECT:

Single photon emission computed tomography

SUV:

Standardized uptake value

%ID:

Percentage of injected dose

HMDP:

Hydroxy-dimethylene diphosphonate

LVEF:

Left ventricular ejection fraction

IVS:

Inter-ventricular septum

HLR:

Heart-to-lung SUVmax ratio

MBR:

Muscle-to-bone SUVmax ratio

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Authors and Affiliations

  1. Normandie Univ, UNICAEN, Signalisation, électrophysiologie et imagerie des lésions d’ischémie-reperfusion myocardique, FHU REMOD-VHF, Caen, France

    Dimitri Bellevre MD, Denis Agostini MD, PhD & Alain Manrique MD, PhD

  2. Department of Nuclear Medicine, UF 5881, Groupement des Hôpitaux de l’Institut Catholique de Lille, Lomme, France

    Dimitri Bellevre MD, Alban Bailliez MD, PhD & Tanguy Blaire MD, PhD

  3. Department of Nuclear Medicine, CHU Cote de Nacre, Normandy University, Caen, France

    Denis Agostini MD, PhD & Alain Manrique MD, PhD

  4. Department of Nuclear Medicine, IRIS, Hôpital Privé Le Bois, Lille, France

    Dimitri Bellevre MD, Alban Bailliez MD, PhD & Tanguy Blaire MD, PhD

  5. Department of Cardiology, Groupement des Hopitaux de l’instituts catholiques de Lille, Lomme, France

    François Delelis MD & Sylvestre Maréchaux MD, PhD

  6. Department of Cardiology, Hôpital Privé Le Bois, Lille, France

    Frédéric Mouquet MD, PhD

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  1. Dimitri Bellevre MD
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  2. Alban Bailliez MD, PhD
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Correspondence to Dimitri Bellevre MD.

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Informed consent was obtained from all individual participants included in the study.

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Annex

Annex

See Table 3.

Table 3 Patients characteristics
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Bellevre, D., Bailliez, A., Delelis, F. et al. Quantitation of myocardial 99mTc-HMDP uptake with new SPECT/CT cadmium zinc telluride (CZT) camera in patients with transthyretin-related cardiac amyloidosis: Ready for clinical use?. J. Nucl. Cardiol. 29, 506–514 (2022). https://doi.org/10.1007/s12350-020-02274-2

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