The JSNC-ASNC joint symposium in the 33rd JSNC annual meeting was held on Jun. 24th, and we invited Prof. Mouaz H. Al-Mallah, who was the president of ASNC and requested the lecture entitled “Comparison of MPI and FFRCT”. He introduced several cases and evidences reported previously, and summarized the current status of FFRCT, especially about the diagnostic performance, prognostic value, and proper use, compared to MPI.
第33届JSNC年会JSNC-ASNC联合研讨会于6月24日召开，我们邀请了ASNC主席Mouaz H. Al-Mallah教授做题为“MPI和FFRCT的比较”的讲座。他介绍了之前报道的几个病例和证据，并总结了FFRCT的现状，特别是与MPI相比，FFRCT的诊断性能、预后价值和正确使用。
{"title":"The Report of ASNC-JSNC Joint Symposium in JSNC 33<sup>rd</sup> Annual Scientific Meeting","authors":"Keisuke Kiso","doi":"10.17996/anc.23-00012","DOIUrl":"https://doi.org/10.17996/anc.23-00012","url":null,"abstract":"The JSNC-ASNC joint symposium in the 33rd JSNC annual meeting was held on Jun. 24th, and we invited Prof. Mouaz H. Al-Mallah, who was the president of ASNC and requested the lecture entitled “Comparison of MPI and FFRCT”. He introduced several cases and evidences reported previously, and summarized the current status of FFRCT, especially about the diagnostic performance, prognostic value, and proper use, compared to MPI.","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135261609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
18F-flurpiridaz is a novel positron emission computed tomography (PET) tracer in ongoing clinical trials in United States and Japan. A phase III prospective, open-label, multi-center study to assess the feasibility of 18F-flurpiridaz was reported by Maddahi et al. in patients with known or suspected coronary artery disease (CAD) in 2020 in United States (1). 18F-flurpiridaz binds to mitochondrial complex 1 and would distribute to the myocardium with its higher extraction fraction than those in single-photon emission computed tomography (SPECT) tracers (2). In that phase III trial, 795 participants with known or suspected CAD showed that sensitivity of 18F-flurpiridaz PET (for detection of ≥50% stenosis by invasive coronary angiography) was 71.9%, significantly (p < 0.001) higher than 99mTc labeled SPECT agent (53.7%), while specificity did not meet the prespecified noninferiority criterion (76.2% vs. 86.6%, p=NS) (1). Therefore, a second phase III Food and Drug Administration trial was planned and completed by GE Healthcare. Late phase II open-label multicenter study of PET scan using 18F-flurpiridaz (named NMB58 in Japan) to assess myocardial blood flow and diagnostic feasibility in patients with known or suspected CAD started in Japan of 2023.
18F-flurpiridaz是一种新型的正电子发射计算机断层扫描(PET)示踪剂，目前正在美国和日本进行临床试验。Maddahi等人于2020年在美国报道了一项III期前瞻性、开放标签、多中心研究，以评估18F-flurpiridaz在已知或疑似冠状动脉疾病(CAD)患者中的可行性(1)。与单光子发射计算机断层扫描(SPECT)示踪剂相比，18F-flurpiridaz与线粒体复合物1结合，可分布到心肌(2)。在该III期试验中，795名已知或疑似CAD患者显示，18F-flurpiridaz PET(通过有创冠状动脉造影检测≥50%狭窄)的敏感性为71.9%，显著(p < 0.001)高于99mTc标记的SPECT(53.7%)，而特异性不符合预定的非效性标准(76.2% vs. 86.6%， p=NS)(1)。因此，GE Healthcare计划并完成了第二项III期食品和药物管理局试验。2023年，日本开始使用18F-flurpiridaz(日本命名为NMB58)进行PET扫描的晚期II期开放标签多中心研究，以评估已知或疑似CAD患者的心肌血流量和诊断可行性。
{"title":"Progress of <sup>18</sup>F-flurpiridaz in Clinical Trials","authors":"Naoya Matsumoto","doi":"10.17996/anc.23-00011","DOIUrl":"https://doi.org/10.17996/anc.23-00011","url":null,"abstract":"18F-flurpiridaz is a novel positron emission computed tomography (PET) tracer in ongoing clinical trials in United States and Japan. A phase III prospective, open-label, multi-center study to assess the feasibility of 18F-flurpiridaz was reported by Maddahi et al. in patients with known or suspected coronary artery disease (CAD) in 2020 in United States (1). 18F-flurpiridaz binds to mitochondrial complex 1 and would distribute to the myocardium with its higher extraction fraction than those in single-photon emission computed tomography (SPECT) tracers (2). In that phase III trial, 795 participants with known or suspected CAD showed that sensitivity of 18F-flurpiridaz PET (for detection of ≥50% stenosis by invasive coronary angiography) was 71.9%, significantly (p < 0.001) higher than 99mTc labeled SPECT agent (53.7%), while specificity did not meet the prespecified noninferiority criterion (76.2% vs. 86.6%, p=NS) (1). Therefore, a second phase III Food and Drug Administration trial was planned and completed by GE Healthcare. Late phase II open-label multicenter study of PET scan using 18F-flurpiridaz (named NMB58 in Japan) to assess myocardial blood flow and diagnostic feasibility in patients with known or suspected CAD started in Japan of 2023.","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":"167 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135261401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Koichi Okuda, Kenichi Nakajima, Guang-Uei Hung, Hao-Ting Wu, Derk O. Verschure, Hein J. Verberne, Chiemi Kitamura
Background: Cross-calibration of 123I-labeled meta-iodobenzylguanidine (mIBG) myocardial-derived indices is essential to extrapolate findings from several clinical centers. Here, we conducted a phantom study to generate conversion coefficients for the calibration of heart-to-mediastinum ratios and compare them between Taiwan and Europe. Methods: We used an acrylic phantom dedicated to 123I-mIBG planar imaging to calculate the conversion coefficients of 136 phantom images derived from 36 Taiwanese institutions. A European phantom image database including 191 images from 27 institutions was used. Conversion coefficients were categorized into five collimator types: low-energy (LE) high-resolution (LEHR), LE general-purpose (LEGP), extended LEGP (ELEGP), medium-energy (ME) GP (MEGP), and ME low-penetration (MELP) collimators. Results: The conversion coefficients were 0.53 ± 0.039, 0.59 ± 0.032, 0.79 ± 0.032, 0.96 ± 0.038, and 0.99 ± 0.050 for LEHR, LEGP, ELEGP, MEGP, and MELP collimators, respectively. The Taiwanese and European conversion coefficients for the LEHR, LEGP, and MELP collimators did not significantly differ. The coefficient of variation was slightly higher for the Taiwanese than the European conversion coefficients (3.7%–7.5% vs. 2.3%–5.6%). Conclusions: We calculated conversion coefficients for various types of collimators used in Taiwan using a 123I-mIBG phantom. In general, the Taiwanese and European conversion coefficients were comparable. These findings further corroborated and highlighted the need for 123I-mIBG standardization using the phantom-determined conversion coefficients.
{"title":"Comparison of Taiwanese and European Calibration Factors for Heart-to-Mediastinum Ratio in Multicenter <sup>123</sup>I-mIBG Phantom Studies","authors":"Koichi Okuda, Kenichi Nakajima, Guang-Uei Hung, Hao-Ting Wu, Derk O. Verschure, Hein J. Verberne, Chiemi Kitamura","doi":"10.17996/anc.23-00006","DOIUrl":"https://doi.org/10.17996/anc.23-00006","url":null,"abstract":"Background: Cross-calibration of 123I-labeled meta-iodobenzylguanidine (mIBG) myocardial-derived indices is essential to extrapolate findings from several clinical centers. Here, we conducted a phantom study to generate conversion coefficients for the calibration of heart-to-mediastinum ratios and compare them between Taiwan and Europe. Methods: We used an acrylic phantom dedicated to 123I-mIBG planar imaging to calculate the conversion coefficients of 136 phantom images derived from 36 Taiwanese institutions. A European phantom image database including 191 images from 27 institutions was used. Conversion coefficients were categorized into five collimator types: low-energy (LE) high-resolution (LEHR), LE general-purpose (LEGP), extended LEGP (ELEGP), medium-energy (ME) GP (MEGP), and ME low-penetration (MELP) collimators. Results: The conversion coefficients were 0.53 ± 0.039, 0.59 ± 0.032, 0.79 ± 0.032, 0.96 ± 0.038, and 0.99 ± 0.050 for LEHR, LEGP, ELEGP, MEGP, and MELP collimators, respectively. The Taiwanese and European conversion coefficients for the LEHR, LEGP, and MELP collimators did not significantly differ. The coefficient of variation was slightly higher for the Taiwanese than the European conversion coefficients (3.7%–7.5% vs. 2.3%–5.6%). Conclusions: We calculated conversion coefficients for various types of collimators used in Taiwan using a 123I-mIBG phantom. In general, the Taiwanese and European conversion coefficients were comparable. These findings further corroborated and highlighted the need for 123I-mIBG standardization using the phantom-determined conversion coefficients.","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135312461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Technetium-99m pyrophosphate single photon emission computed tomography (99mTc-PYP SPECT) imaging is widely used to diagnose cardiac amyloidosis, a disease characterized by amyloid protein deposits in the myocardium. The effects of viewing perspectives on interobserver agreement in the interpretation of 99mTc-PYP SPECT images for the diagnosis of cardiac amyloidosis remain unclear.Methods: A retrospective analysis of 32 consecutive patients who underwent 99mTc-PYP imaging for the diagnosis of cardiac amyloidosis at Nagasaki University Hospital between October 2017 and February 2020 was performed. Four evaluators independently reviewed coronal, sagittal, and transaxial images and then all images together and made a categorical diagnosis based on predefined criteria. Interobserver agreement was analyzed using Cohen's Kappa analysis.Results: Kappa coefficient values in the four-grade grading system (grades 0–3) ranged between 0.31 and 0.95, while those in the binary grading system (positive/negative) ranged between 0.88 and 1. The sagittal view showed the highest value in the four-grade grading system (0.95) and the lowest in the binary grading system (0.88). The transaxial view was more likely to show a consistently high kappa value in both the four-grade and binary grading systems. The use of the multiplanar view reduced the number of subjects classified as grade 1.Conclusion: Our study demonstrates that the transaxial view provides the most consistent interpretation of 99mTc-PYP SPECT images for the diagnosis of cardiac amyloidosis. The use of the multiplanar view may also reduce equivocal interpretations, which are graded as grade 1. Further studies with larger sample sizes and a quantitative analysis are needed to confirm the present results.
{"title":"Assessment of Interobserver Agreement in the Interpretation of <sup>99m</sup>Tc-PYP SPECT Imaging of Cardiac Amyloidosis","authors":"Aiganym Imakhanova, Reiko Ideguchi, Akiyo Chiba, Takashi Kudo","doi":"10.17996/anc.23-00004","DOIUrl":"https://doi.org/10.17996/anc.23-00004","url":null,"abstract":"Background: Technetium-99m pyrophosphate single photon emission computed tomography (99mTc-PYP SPECT) imaging is widely used to diagnose cardiac amyloidosis, a disease characterized by amyloid protein deposits in the myocardium. The effects of viewing perspectives on interobserver agreement in the interpretation of 99mTc-PYP SPECT images for the diagnosis of cardiac amyloidosis remain unclear.Methods: A retrospective analysis of 32 consecutive patients who underwent 99mTc-PYP imaging for the diagnosis of cardiac amyloidosis at Nagasaki University Hospital between October 2017 and February 2020 was performed. Four evaluators independently reviewed coronal, sagittal, and transaxial images and then all images together and made a categorical diagnosis based on predefined criteria. Interobserver agreement was analyzed using Cohen's Kappa analysis.Results: Kappa coefficient values in the four-grade grading system (grades 0–3) ranged between 0.31 and 0.95, while those in the binary grading system (positive/negative) ranged between 0.88 and 1. The sagittal view showed the highest value in the four-grade grading system (0.95) and the lowest in the binary grading system (0.88). The transaxial view was more likely to show a consistently high kappa value in both the four-grade and binary grading systems. The use of the multiplanar view reduced the number of subjects classified as grade 1.Conclusion: Our study demonstrates that the transaxial view provides the most consistent interpretation of 99mTc-PYP SPECT images for the diagnosis of cardiac amyloidosis. The use of the multiplanar view may also reduce equivocal interpretations, which are graded as grade 1. Further studies with larger sample sizes and a quantitative analysis are needed to confirm the present results.","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":"106 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135702225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The use of 201Tl in myocardial perfusion single-photon emission computed tomography (SPECT) is predominantly not recommended because of the higher radiation exposure of 201Tl compared to 99mTc agent. However, the advent of new gamma cameras with semiconductor detectors has made it possible to reduce the 201Tl dose and lower radiation exposure. In our hospital, the dose of 201Tl is adjusted according to the patient's body mass index (BMI), with 50 MBq for BMI<25 and 74 MBq for BMI≥25. The dose of 201Tl during simultaneous acquisition dual-isotope myocardial perfusion SPECT (MPS; stress 201Tl and rest 99mTc agent) exceeds 9 mSv/examination when 74 MBq of 201Tl is administered. In order to further reduce the radiation dose, optimization of the 201Tl dose was investigated.Methods: Two hundred and eighty consecutive patients who underwent stress MPS using simultaneous acquisition dual-isotope protocol (SDI protocol) for the estimation of ischemic heart disease were included. Patients with prior myocardial infarction were excluded. Correlations between BMI and acquisition time were determined in patients receiving 50 MBq (n=154) or 74 MBq (n=126) of 201Tl. In addition, linear regression analysis was used to determine the slope and intercept to derive a linear functional equation, and the theoretically optimal 201Tl dose was evaluated.Results: The correlation coefficient between BMI and acquisition time in the 201Tl 50 MBq group was 0.532 (P < 0.00001) and in the 201Tl 74 MBq group was 0.478 (P < 0.00001), both showing a positive correlation. Linear regression analysis yielded two equations: y=0.52x-0.32 (201Tl 50 MBq group) and y=0.41x-0.69 (201Tl 74 MBq group). Linear function equation results indicated that patients with BMI between 25 and 30 could be examined within approximately 15 minutes with 50 MBq of 201Tl.Conclusion: Considering examination efficiency, a single acquisition time of less than 15 minutes is ideal. Theoretically, patients with BMI less than 30 could be examined within approximately 15 minutes with 50 MBq of 201Tl.
{"title":"Optimization of <sup>201</sup>Tl Dosage in a Simultaneous Acquisition Rest <sup>99m</sup>Tc/Stress <sup>201</sup>Tl Dual-Isotope Myocardial Perfusion Single-Photon Emission Computed Tomography with Semiconductor Gamma Camera","authors":"Shonosuke Sugai, Naoya Matsumoto, Ayano Makita, Keiichiro Kuronuma, Yasuyuki Suzuki, Yoshitaka Hori, Shunichi Yoda, Yasuo Okumura, Yasuo Amano","doi":"10.17996/anc.23-00010","DOIUrl":"https://doi.org/10.17996/anc.23-00010","url":null,"abstract":"Background: The use of 201Tl in myocardial perfusion single-photon emission computed tomography (SPECT) is predominantly not recommended because of the higher radiation exposure of 201Tl compared to 99mTc agent. However, the advent of new gamma cameras with semiconductor detectors has made it possible to reduce the 201Tl dose and lower radiation exposure. In our hospital, the dose of 201Tl is adjusted according to the patient's body mass index (BMI), with 50 MBq for BMI<25 and 74 MBq for BMI≥25. The dose of 201Tl during simultaneous acquisition dual-isotope myocardial perfusion SPECT (MPS; stress 201Tl and rest 99mTc agent) exceeds 9 mSv/examination when 74 MBq of 201Tl is administered. In order to further reduce the radiation dose, optimization of the 201Tl dose was investigated.Methods: Two hundred and eighty consecutive patients who underwent stress MPS using simultaneous acquisition dual-isotope protocol (SDI protocol) for the estimation of ischemic heart disease were included. Patients with prior myocardial infarction were excluded. Correlations between BMI and acquisition time were determined in patients receiving 50 MBq (n=154) or 74 MBq (n=126) of 201Tl. In addition, linear regression analysis was used to determine the slope and intercept to derive a linear functional equation, and the theoretically optimal 201Tl dose was evaluated.Results: The correlation coefficient between BMI and acquisition time in the 201Tl 50 MBq group was 0.532 (P < 0.00001) and in the 201Tl 74 MBq group was 0.478 (P < 0.00001), both showing a positive correlation. Linear regression analysis yielded two equations: y=0.52x-0.32 (201Tl 50 MBq group) and y=0.41x-0.69 (201Tl 74 MBq group). Linear function equation results indicated that patients with BMI between 25 and 30 could be examined within approximately 15 minutes with 50 MBq of 201Tl.Conclusion: Considering examination efficiency, a single acquisition time of less than 15 minutes is ideal. Theoretically, patients with BMI less than 30 could be examined within approximately 15 minutes with 50 MBq of 201Tl.","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135261394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Since 2007, The Japanese Society of Nuclear Cardiology (JSNC) has been conducting regional training workshops on film reading for physicians and technologists who are just beginning their career in cardiac nuclear medicine examinations. JSNC will continue this workshop to expand the fields of cardiac nuclear medicine examinations.
{"title":"Report on the Regional Workshop on Image Reading Conducted by the Japanese Society of Nuclear Cardiology","authors":"Kazuya Takehana","doi":"10.17996/anc.23-00013","DOIUrl":"https://doi.org/10.17996/anc.23-00013","url":null,"abstract":"Since 2007, The Japanese Society of Nuclear Cardiology (JSNC) has been conducting regional training workshops on film reading for physicians and technologists who are just beginning their career in cardiac nuclear medicine examinations. JSNC will continue this workshop to expand the fields of cardiac nuclear medicine examinations.","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135317241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Collaboration of People and Society","authors":"Naoya Matsumoto","doi":"10.17996/anc.23-001","DOIUrl":"https://doi.org/10.17996/anc.23-001","url":null,"abstract":"","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135260761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Highlights of the 33<sup>rd</sup> JSNC Annual Scientific Meeting in Nagasaki","authors":"Takashi Kudo","doi":"10.17996/anc.23-002","DOIUrl":"https://doi.org/10.17996/anc.23-002","url":null,"abstract":"","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135261196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"JSNC 2024 in Omiya","authors":"Ichiro Matsunari","doi":"10.17996/anc.23-003","DOIUrl":"https://doi.org/10.17996/anc.23-003","url":null,"abstract":"","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135313185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: A three-dimensional (3D) approach to absolute quantitation of 123I-metaiodobenzylguanidine (MIBG) sympathetic nerve imaging using single-photon emission tomography (SPECT) / computed tomography (CT) is not available. Therefore, we calculated absolute cardiac counts and standardized uptake values (SUVs) from images of 72 consecutive patients with cardiac and neurological diseases using 123I-MIBG SPECT/CT and compared them with conventional planar quantitation. We aimed to develop new methods for 3D heart segmentation and the quantitation of these diseases. Methods: We manually segmented early and late SPECT/CT images of the heart in 3D, then calculated mean (SUVmean) and maximum (SUVmax) SUVs. We analyzed correlations between SUVs and planar heart-to-mediastinum ratios (HMRs), and between washout rates (WRs) derived from the SUVs and planar data. We also categorized WRs as normal or abnormal using linear regression lines determined by the relationship between SPECT/CT and planar WRs, and assessed agreement between them. Results: We calculated SUVmean and SUVmax from all early and late 123I-MIBG SPECT/CT images. Planar HMRs correlated with early and late SUVmean (R2=0.59 and 0.73, respectively) and SUVmax (R2=0.46 and 0.60, respectively; both p<0.0001). The SPECT/CT WRs determined based on SUVmean and SUVmax (R2=0.79 and 0.45, p<0.0001) closely correlated with planar WRs. Agreement of high and low WRs between planar WRs and SPECT/CT WRs calculated using SUVmax and SUVmean reached 88.1% and 94.4% respectively. Conclusions: We found that sympathetic nervous activity could be absolutely quantified in 3D from 123I-MIBG SPECT/CT images. Therefore, we propose a new method for quantifying sympathetic innervation on SPECT/CT images.
{"title":"Three-Dimensional Heart Segmentation and Absolute Quantitation of Cardiac <sup>123</sup>I-metaiodobenzylguanidine Sympathetic Imaging Using SPECT/CT","authors":"Shintaro Saito, Kenichi Nakajima, Takayuki Shibutani, Hiroshi Wakabayashi, Hiroto Yoneyama, Takahiro Konishi, Hiroshi Mori, Aki Takata, Seigo Kinuya","doi":"10.17996/anc.23-00002","DOIUrl":"https://doi.org/10.17996/anc.23-00002","url":null,"abstract":"Background: A three-dimensional (3D) approach to absolute quantitation of 123I-metaiodobenzylguanidine (MIBG) sympathetic nerve imaging using single-photon emission tomography (SPECT) / computed tomography (CT) is not available. Therefore, we calculated absolute cardiac counts and standardized uptake values (SUVs) from images of 72 consecutive patients with cardiac and neurological diseases using 123I-MIBG SPECT/CT and compared them with conventional planar quantitation. We aimed to develop new methods for 3D heart segmentation and the quantitation of these diseases. Methods: We manually segmented early and late SPECT/CT images of the heart in 3D, then calculated mean (SUVmean) and maximum (SUVmax) SUVs. We analyzed correlations between SUVs and planar heart-to-mediastinum ratios (HMRs), and between washout rates (WRs) derived from the SUVs and planar data. We also categorized WRs as normal or abnormal using linear regression lines determined by the relationship between SPECT/CT and planar WRs, and assessed agreement between them. Results: We calculated SUVmean and SUVmax from all early and late 123I-MIBG SPECT/CT images. Planar HMRs correlated with early and late SUVmean (R2=0.59 and 0.73, respectively) and SUVmax (R2=0.46 and 0.60, respectively; both p<0.0001). The SPECT/CT WRs determined based on SUVmean and SUVmax (R2=0.79 and 0.45, p<0.0001) closely correlated with planar WRs. Agreement of high and low WRs between planar WRs and SPECT/CT WRs calculated using SUVmax and SUVmean reached 88.1% and 94.4% respectively. Conclusions: We found that sympathetic nervous activity could be absolutely quantified in 3D from 123I-MIBG SPECT/CT images. Therefore, we propose a new method for quantifying sympathetic innervation on SPECT/CT images.","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135316655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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