A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

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

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 withhigher 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.Propos. L’objectif de l’étude est de comparer différentes méthodes d’analyse semi-quantitative de la fixation myocardique en scintigraphie osseuse au 99mTc-biphosphonate chez des patients adressés pour suspicion d'amylose cardiaque à transthyrétine. Matériel. Des données sur 67 patients ont été recueillies et analysées rétrospectivement chez des patients ayant réalisé une scintigraphie osseuse et une SPECT myocardique sur caméra CZT 3 heures après injection de 99mTc-biphosphonate. Une analyse visuelle de la fixation cardiaque a été réalisée sur les images planaires selon le score de Perugini. Des ratios ont été calculés sur les images planaires (wb-H:B) et tomographiques : rétroprojections antérieures (ant-H:B), obliques antérieures gauches (LAO-H:B) et volumiques (3D-H:B). L’épaisseur septale a été obtenue à partir des données de l’échographie cardiaque. Résultats. Les ratios (H:B) wb-H:B, ant-H:B et LAO-H:B ne sont pas significativement différents (p=ns). Cependant, les ratios volumiques (3D-H:B) sont significativement plus élevés comparés aux ratios planaires (3D-H:B, 4.06±1.77, all P<0.0001 vs. wb-H:B, ant-H:B and LAO-H:B). L’analyse de Bland-Altman montre une augmentation de la différence entre les ratios volumiques et planaires avec la valeur moyenne de la fixation cardiaque. Les ratios volumiques (3D-H:B) sont mieux corrélés à l’épaisseur septale (r= 0.45, p< 0.001). Enfin, la fixation anormale du ventricule droit est associée à une fixation myocardique plus élevée. Conclusion. L’analyse semi-quantitative sur caméra CZT SPECT optimise l’évaluation de la fixation myocardique du 99mTc-biphosphonate chez les patients ayant une amylose cardiaque à TTR

The utility of pharmacological and radiological interventions to optimize diagnostic information from PET/CT

Abstract Background Positron Emission Tomography with Computed Tomography (PET/CT) is widely used in the assessment of many diseases, particularly including cancer. However, many factors can affect image quality and diagnostic performance of PET scans using FDG or other PET probes. Main body The aim of this pictorial essay is to review PET/CT protocols that can be useful to overcome these confounding factors in routine clinical situations, with a particular focus on pharmacological interventions and problem-oriented CT acquisition protocols. Conclusion Imaging protocols and representative cases will be discussed, in addition to potential contraindications and precautions to be taken. </jats:sec

The utility of pharmacological and radiological interventions to optimize diagnostic information from PET/CT

BACKGROUND: Positron Emission Tomography with Computed Tomography (PET/CT) is widely used in the assessment of many diseases, particularly including cancer. However, many factors can affect image quality and diagnostic performance of PET scans using FDG or other PET probes. MAIN BODY: The aim of this pictorial essay is to review PET/CT protocols that can be useful to overcome these confounding factors in routine clinical situations, with a particular focus on pharmacological interventions and problem-oriented CT acquisition protocols. CONCLUSION: Imaging protocols and representative cases will be discussed, in addition to potential contraindications and precautions to be taken

Quantification of myocardial 99mTc-labeled bisphosphonate uptake with cadmium zinc telluride camera in patients with transthyretin-related cardiac amyloidosis

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 whole-body scan and a CZT myocardial SPECT (DSPECT, Spectrum Dynamics) 3 h after injection of 99mTc-labeled bone tracer were analyzed. Visual scoring of cardiac retention was performed on whole-body scan according to Perugini 4-point grading system from 0 (no uptake) to 3 (strong cardiac uptake with mild/absent bone uptake). A planar heart-to-background (H:B) ratio was calculated using whole-body scan (wb-H:B). CZT SPECT was quantified using three 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 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 &lt; 0.0001 vs. wb-H: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 &lt; 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 99mTc-labeled bone tracer myocardial uptake in patients with cardiac amyloidosis. </jats:sec

Quantification of myocardial 99mTc-labeled bisphosphonate uptake with cadmium zinc telluride camera in patients with transthyretin-related cardiac amyloidosis

International audienceAbstract 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 whole-body scan and a CZT myocardial SPECT (DSPECT, Spectrum Dynamics) 3 h after injection of 99m Tc-labeled bone tracer were analyzed. Visual scoring of cardiac retention was performed on whole-body scan according to Perugini 4-point grading system from 0 (no uptake) to 3 (strong cardiac uptake with mild/absent bone uptake). A planar heart-to-background (H:B) ratio was calculated using whole-body scan (wb-H:B). CZT SPECT was quantified using three 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 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 &lt; 0.0001 vs. wb-H: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 &lt; 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 99m Tc-labeled bone tracer myocardial uptake in patients with cardiac amyloidosis