Title Nuo planarinio link tūrinio vaizdinimo: naujos kartos gama kamerų detektorių įtaka širdies ir priešingos plaučio srities santykio tikslumui diagnozuojant širdies amiloidozę
Translation of Title From two-dimensional to three-dimensional imaging: the impact of new-generation gamma camera on the accuracy of the heart-tocontralateral lung ratio in the diagnosis of cardiac amyloidosis.
Authors Mickevičiūtė, Karina ; Bielinis, Augustinas ; Komiagienė, Renata
DOI 10.53453/ms.2026.5.14
Full Text Download
Is Part of Medicinos mokslai = Journal of medical science.. Kėdainiai : VšĮ Lietuvos sveikatos mokslinių tyrimų centras. 2026, vol. 14, iss. 3, p. 115-125.. eISSN 2345-0592
Keywords [eng] cardiac amyloidosis ; radionuclide imaging ; single-photon emission computed tomography ; heart-tocontralateral lung ratio ; Perugini score
Abstract [eng] Background. Cardiac amyloidosis is an infiltrative cardiomyopathy whose early diagnosis remains challenging due to nonspecific clinical manifestations, often leading to delayed detection. Although radionuclide scintigraphy with 99mTc-PYP enables non-invasive diagnosis of transthyretin (ATTR) cardiac amyloidosis, discrepancies between visual (Perugini) and semi-quantitative (H/CL) assessments remain a significant issue. Objective. To evaluate H/CL ratio values using different scintigraphic methods (2D and 3D), assess their associations with the Perugini score and cardiac MRI parameters, and compare the impact of different methodologies on diagnostic decision-making in ATTR cardiac amyloidosis. Methods. A retrospective analysis of 162 patients who underwent 99mTc-PYP scintigraphy was performed. The H/CL ratio was assessed using 2D and 3D methods, and the Perugini score was determined. Cardiac MRI parameters were available for a subset of patients. Non-parametric methods, Spearman correlation, and ROC analysis were applied. Results. A significant correlation was found between the H/CL ratio and the Perugini score (ρ=0.663–0.760; p 0.001), as well as between imaging methods. The 3D H/CL ratio showed greater variability but excellent diagnostic accuracy in differentiating Perugini 0–1 and 2–3 groups (AUC=0.943). For diagnosing cardiac amyloidosis, the 3D H/CL ratio demonstrated good performance (AUC=0.848) with an optimal cut-off of 1.35. A moderate correlation was observed with extracellular volume (ECV) (ρ=0.548; p=0.003), while no association was found with T1 relaxation time, late gadolinium enhancement, or myocardial hypertrophy. Conclusions. The H/CL ratio is a reliable semi-quantitative parameter associated with the Perugini score and ECV. Three-dimensional imaging provides high diagnostic accuracy and additional value, particularly in equivocal cases. The H/CL ratio should be interpreted alongside visual assessment and clinical data.
Published Kėdainiai : VšĮ Lietuvos sveikatos mokslinių tyrimų centras
Type Journal article
Language Lithuanian
Publication date 2026
CC license CC license description