Semi-quantitative indices of cardiac uptake in patients with suspected cardiac amyloidosis undergoing 99mTc-HMDP scintigraphy
| Autor: | Chiara Gallini, Simone Bartolini, Sofia Morini, E. Costanzo, Raffaele Martone, Alfonso Ciaccio, Carlo Di Mario, Giulia Taborchi, Francesca Tutino, Francesco Cappelli, Federico Perfetto, Silvia Farsetti |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Heart Diseases Technetium Tc 99m Medronate 030204 cardiovascular system & hematology Scintigraphy 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Amyloid heart disease molecular imaging agents SPECT Radiology Nuclear Medicine and Imaging Cardiology and Cardiovascular Medicine Predictive Value of Tests medicine Humans Whole Body Imaging Radiology Nuclear Medicine and imaging In patient Radionuclide Imaging Aged Retrospective Studies Aged 80 and over Observer Variation medicine.diagnostic_test business.industry Confounding Area under the curve Soft tissue Amyloidosis Middle Aged Cardiac amyloidosis Background Correction Female Radiopharmaceuticals Nuclear medicine business Semi quantitative |
| Popis: | 99mTc-HMDP scintigraphy has proved its efficacy in non-invasive diagnosis of cardiac amyloidosis (CA) and is currently interpreted according to the Perugini qualitative assessment. Several semi-quantitative indices have been proposed to overcome inherent possible limitations of visual grading. Our aim was to comparatively evaluate six different indices and their diagnostic performance. We retrospectively reviewed scintigraphy of 76 patients (53 ATTR, 12 AL, 11 LVH) who underwent diagnostic evaluation at our centre. ROC-curve analysis was performed to identify optimal cut-off and relative diagnostic accuracy of six different indices (of which one was proposed for the first time), both in identifying CA patients and in discriminating patients according to their Perugini score. Heart/Whole-body ratios proved to be the most accurate (100%) in identifying CA patients. Heart/Pelvis ratio (with soft tissue background correction) offered acceptable accuracy (98%), with the largest area under the curve (AUC) (0.98) in discriminating patients with Perugini ≥ 2. Heart/Contralateral Lung ratio confirmed to be exposed to confounding background noise in case of simultaneous lung uptake. Heart/Skull ratio had the worst performance, with six false-negative patients in ATTR identification. Heart/Whole-body ratios may be robust and effective semi-quantitative indices for the evaluation of CA by means of scintigraphy |
| Databáze: | OpenAIRE |
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