ArticleEJNMMI reports2026
Diagnostic and prognostic value of
Article in EJNMMI reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThis study evaluated the diagnostic and prognostic values of Technetium- 99m pyrophosphate (99mTc-PYP) scintigraphy using single-photon emission computed tomography/ computed tomography (SPECT/CT) in patients with transthyretin amyloid cardiomyopathy (ATTR-CM).
methodsAmong 206 consecutive patients with suspected cardiac amyloidosis who underwent 99mTc-PYP scintigraphy using SPECT/CT and had no evidence of monoclonal protein, 20 patients were diagnosed with ATTR-CM based on SPECT/CT interpretation, whereas183 had no diagnostic findings on SPECT/CT interpretation. We calculated 99mTc-PYP activity in the volume of interest (VOI) for the myocardium and upper aorta for the blood pool as a reference. The heart-to-blood ratio (HBR) was calculated by dividing the mean activity in the VOI of the myocardium by that in the VOI of the upper aorta. Receiver-operating-characteristic (ROC) analysis was used to assess the diagnostic value of the Perugini grade, HBR, and heart-to-contralateral ratio (H/CL). A multivariate Cox model was used to assess whether the parameters, including HBR, were associated with all-cause mortality, cardiac death, and hospitalization for heart failure.
resultsBy ROC analysis, HBR had the most diagnostic value (HBR area under the curve [AUC]: 0.997, 95% confidence interval [CI] 0.990–1.000 vs. H/CL AUC: 0.9617, 95% CI 0.942–0.981 vs. Perugini grade AUC: 0.918, 95% CI 0.891–0.945). During a mean follow-up period of 531 days, 38 major adverse cardiac events occurred. Multivariable Cox models showed that HBR was the most significant prognostic factor (hazard ratio 2.715, 95% CI 1.185–6.221, p = 0.018).
conclusionsThis study demonstrated that HBR calculated by 99mTc-PYP scintigraphy using SPECT/CT could have potential diagnostic and prognostic value in patients with ATTR-CM.
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