ArticleEuropean journal of nuclear medicine and molecular imaging2026
Quantitative
Article in European journal of nuclear medicine and molecular imaging, 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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6 authors.
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Abstract
purposeScintigraphy using
methodsIn this retrospective single-center study, 170 patients with suspected cardiac amyloidosis underwent 99mTc-PYP scintigraphy, including planar imaging and SPECT/CT. Quantitative myocardial uptake was assessed using myocardium-to-vertebra and myocardium-to-rib ratios across predefined left ventricular segments. Imaging findings were correlated with electrocardiographic, echocardiographic, cardiac magnetic resonance (CMR), biomarker, and histopathological data where available.
resultsQuantitative SPECT/CT correlated strongly with Perugini scores and improved diagnostic certainty, particularly in patients with equivocal planar findings. The addition of SPECT/CT led to diagnostic reclassification in more than one-third of patients, with the greatest impact observed in the intermediate Perugini group. Myocardial uptake ratios were significantly associated with NT-proBNP, troponin T, echocardiographic markers of diastolic dysfunction, and CMR parameters including native T1 and extracellular volume. Blood pool activity showed an inverse relationship with myocardial uptake and was associated with both upgrade and downgrade, indicating its role as a confounding factor. Correlation analysis demonstrated only weak associations with renal function and no meaningful correlations with biomarkers or structural parameters. Histopathology (7%) was concordant with imaging findings.
conclusionQuantitative SPECT/CT at 90 min p.i. provides significant incremental diagnostic value, particularly in equivocal cases. Its ability to improve diagnostic classification and distinguish true myocardial uptake from blood pool activity supports its integration into routine diagnostic algorithms for ATTR-CM.
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