Volumetric uptake analysis for Amyloidosis
Starting with Cardiac Suite version 2017.24, the Fusion page gains new abilities with the Measure functionality for ROI-based volumetric quantitative assessment of inflammatory disease states or other uptake-based workflows. These tools include amyloidosis- and sarcoidosis-specific measurements as well as a generic target-to-background ratio mode, and more. For amyloidosis, these features may be used in conjunction with planar tools available in the Raw page.
For the assessment of amyloidosis, quantitative or visual evaluation of the SPECT or, preferably, SPECT/CT images helps distinguish myocardial activity from blood pool activity. PET/CT is used for the assessment of sarcoidosis <link to sarcoidosis page> using similar tools.
The Fusion page’s Amyloid Measure mode computes 3D metrics for the assessment of cardiac amyloid burden.
Planar analysis
The classic heart-to-contralateral-lung ratio is also available in the Planar page’s Amyloid Measure mode. Optional ROI mirroring should be initially enabled for easy ROI placement and sizing, and then turned off if so desired to fine tune the contralateral lung ROI (e.g., to avoid excessive rib activity).
References
- Miller RJH, et al. Diagnostic and prognostic value of Technetium-99m pyrophosphate uptake quantitation for transthyretin cardiac amyloidosis. J Nucl Cardiol. 2021 Oct; 28(5):1835-1845.
- Dorbala S, et al. ASNC/AHA/ASE/EANM/HFSA/ ISA/SCMR/SNMMI Expert Consensus Recommendations for Multimodality Imaging in Cardiac Amyloidosis: Part 1 of 2—Evidence Base and Standardized Methods of Imaging. Circulation: Cardiovascular Imaging. 2021 Jul;14(7):e000029.