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Master Thesis

Quantification de la fixation myocardique à la scintigraphie osseuse au 99mTc-bisphosphonate sur caméra CZT dans l’amylose cardiaque à transthyrétine

Abstract : Purpose. We aimed to compare different methods for semi-quantitative analysis of cardiac retention of bone tracers in patients with cardiac transthyretin amyloidosis (ATTR). Methods. Data from 67 patients with ATTR who underwent both conventional wholebody scan and a CZT myocardial SPECT 3 hours after injection of 99mTc-labelled bone tracer were analyzed. Visual scoring of cardiac retention was performed on whole-body scan according to Perugini 4-point grading system. A planar heart-to-background (H:B) ratio was calculated using whole-body scan (wb-H:B). CZT SPECT was quantified using 3 methods: planar H:B ratio calculated from anterior reprojection (ant-H:B), left anterior oblique reprojection (LAO-H:B) and 3D-H:B ratio calculated from transaxial slices as mean counts in a VOI encompassing the heart divided by background VOI in the contralateral lung. Interventricular septal thickness was obtained using echocardiography. Results. All H:Bs obtained from planar and reprojected data were not statistically different (wb-H:B, 2.05±0.64, ant-H:B, 1.97±0.61, LAO-H:B, 2.06±0.64, all P=ns). However, 3D-H:B was increased compared to planar H:Bs (3D-H:B, 4.06±1.77, all P<0.0001 vs wbH:B, ant-H:B and LAO-H:B). Bland-Altman plots demonstrated that the difference between 3D and planar H:Bs increased with the mean value of myocardial uptake. 3D-H:B was best correlated to septal thickness (r= 0.45, p<0.001). Finally, abnormal right ventricular uptake was associated with higher values of cardiac retention. Conclusion. 3D semi-quantitative analysis of CZT SPECT optimized the assessment of 99mTclabelled bone tracer myocardial uptake in patients with cardiac amyloidosis.
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Master Thesis
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Submitted on : Thursday, January 28, 2021 - 5:02:16 PM
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David Dudoignon. Quantification de la fixation myocardique à la scintigraphie osseuse au 99mTc-bisphosphonate sur caméra CZT dans l’amylose cardiaque à transthyrétine. Médecine humaine et pathologie. 2020. ⟨dumas-03124445⟩

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