Top

Published in:

01-10-2012 | Original article

Novel method for quantitative evaluation of cardiac amyloidosis using ²⁰¹TlCl and ^99mTc-PYP SPECT

Authors: Yasushi Yamamoto, Masahisa Onoguchi, Masuo Haramoto, Nobuhiro Kodani, Akio Komatsu, Hajime Kitagaki, Kazuaki Tanabe

Published in: Annals of Nuclear Medicine | Issue 8/2012

Abstract

Objective

The degree of myocardial technetium-^99m-pyrophosphate (^99mTc-PYP) accumulation in cardiac amyloidosis is conventionally evaluated by the PYP score. This method involves qualitative visual evaluation on two-dimensional images. Here, we performed three-dimensional quantitative analysis using software developed in our laboratory.

Methods

We performed dual myocardial imaging using thallium-²⁰¹-chloride (²⁰¹Tl-Cl) and ^99mTc-PYP in cases of suspected cardiac amyloidosis and calculated the PYP accumulation rates of all myocardial pixels showing ^99mTc-PYP accumulation. We defined this procedure as quantitative evaluation of the degree of ^99mTc-PYP accumulation in the myocardium. Patients were divided into two groups with and without a diagnosis of cardiac amyloidosis, and we examined the PYP accumulation rates in both groups. In addition, we examined the PYP scores of the two groups by conventional qualitative evaluation.

Results

The PYP scores of the cardiac amyloidosis group were significantly higher than those of the other group. The PYP accumulation rates of the cardiac amyloidosis group were significantly higher than those of the other group. There were significant differences in the PYP accumulation rate and PYP score between the two groups. There was considered to be a threshold between the two groups in the case of the PYP accumulation rate.

Conclusions

When the threshold of the PYP score was defined as 3+ and that of the PYP accumulation rate as 41.5 %, the sensitivity of the PYP score and PYP accumulation rate was 84.6 %. However, the specificity of the PYP accumulation rate was higher than that of the PYP score. Quantitative evaluation by the PYP accumulation rate of the degree of ^99mTc-PYP accumulation in the myocardium may be useful in the diagnosis of cardiac amyloidosis.

Yamada M, Ikeda S, Higuchi K, Tamaoka A, Takaichi K, Toshiyuki Y, et al. The guideline for the medical care of an amyloidosis ver. 2010. A Ministry of Health, Labour and Welfare research group report. 2010. http://amyloid1.umin.ne.jp/guideline2010.pdf.

Tanaka J, Sawayama T, Hasegawa K. A symptomatography of organopathy and diagnostic procedure to be found in a generalized amyloidosis. Nihon Rinsho. 1991;49(4):841–6.PubMed

Hongo M, Misawa T, Yamada H, Hirayama J, Okubo S, Fujii T, et al. Diagnostic significance of Technetium-^99m-pyrophosphate, technetium-^99m-methylene diphosphonate and gallium-67-citrate scintigraphy in amyloid heart disease a study with AL amyloidosis and familial amyloid polyneuropathy. Nihon Naika Gakkai Zasshi. 1986;75(1):1–8.PubMedCrossRef

Nagatomo Y, Ikushima I, Matsuyama A, Nakagawa S, Koiwaya Y, Kenjiro T. Cardiac manifestations in patient with systemic amyloidosis. Shinzou. 1987;19(3):277–85.

Hongo M, Yamada H, Okubo S, Hirayama J, Fujii T, Kusama S, et al. Cardiac involvement in systemic amyloidosis: myocardial scintigraphic evaluation. J Cardiogr. 1985;15(1):163–80.PubMed

Imamoto T, Morita K, Onodera S, Tanazawa S, Amoh K, Ishikawa Y, et al. Technetium-99m-pyrophosphate single photon emission computed tomography of the heart in familial amyloid polyneuropathy: comparison with thallium-201 myocardial scintigraphy—a case report. Kaku Igaku. 1988;25(10):1117–23.PubMed

Fujii T, Tanaka M, Yazaki Y, Kitabayashi H, Koizumi T, Hongou M, et al. Myocardial scintigraphic studies with 123I-MIBG, 201Tl and 99mTc-PYP in patients with cardiac amyloidosis. Kaku Igaku. 1997;34(11):1033–8.PubMed

Falk RH, Lee VW, Rubinow A, Hood WB, Cohen AS. Sensitivity of technetium-99m-pyrophosphate scintigraphy in diagnosing cardiac amyloidosis. Am J Cardiol. 1983;51(5):826–30.PubMedCrossRef

Falk RH, Lee VW, Rubinow A, Skinner M, Cohen AS. Cardiac technetium-99m pyrophosphate scintigraphy in familial amyloidosis. Am J Cardiol. 1984;54(8):1150–1.PubMedCrossRef

10.

Takezaki M, Ishida Y, Morozumi R, Tani A, Satou H, Hori M, et al. Noninvasive diagnosis of cardiac involvement by technetium-99m-pyrophosphate(Tc-99m PYP) myocardial scintigraphy in 2 case with familial amyloid polyneuropathy and 1 case with secondary amyloidosis. Kaku Igaku. 1989;26(12):1537–43.PubMed

11.

Morozumi R, Hori M, Kamada T, Uehara T, Kusuoka H, Nishimura T, et al. Usefulness of technetium-99m pyrophosphoric acid scintigraphy in cardiac amyloidosis diagnosis. Prog Treat Cardiovasc Dis. 1995;14(1):28–32.

12.

Yoshida K, Akasaka T, Itou H, Otsuji Y, Koyanagi S, Satomi M, et al. Guidelines for the clinical application of echocardiography (JCS2010). The Japanese Circulation Society. (2010) http://www.j-circ.or.jp/guideline/pdf/JCS2010yoshida.d.pdf.

Title: Novel method for quantitative evaluation of cardiac amyloidosis using 201TlCl and 99mTc-PYP SPECT
Authors: Yasushi Yamamoto
Masahisa Onoguchi
Masuo Haramoto
Nobuhiro Kodani
Akio Komatsu
Hajime Kitagaki
Kazuaki Tanabe
Publication date: 01-10-2012
Publisher: Springer Japan
Published in: Annals of Nuclear Medicine / Issue 8/2012
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI: https://doi.org/10.1007/s12149-012-0627-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Novel method for quantitative evaluation of cardiac amyloidosis using ²⁰¹TlCl and ^99mTc-PYP SPECT

Abstract

Objective

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 8/2012

Bronchial anthracofibrosis: a potential false-positive finding on F-18 FDG PET

Correlation between neuropsychological tests and hypoperfusion in MCI patients: anatomical labeling using xjView and Talairach Daemon Software

Reduced heart rate response to dipyridamole in patients undergoing myocardial perfusion SPECT

Imaging characterization of benign and malignant pheochromocytoma or paraganglioma: comparison between MIBG uptake and MR signal intensity ratio

Is there a correlation between symptoms and bone scintigraphic findings in patients with complex regional pain syndrome?

Dual-time-point F-18 FDG PET/CT for evaluation in patients with malignant lymphoma