{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T07:47:11Z","timestamp":1782719231299,"version":"3.54.5"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Jpn J Radiol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Bone-avid tracers, such as\n                      <jats:sup>99m<\/jats:sup>\n                      Tc-pyrophosphate (PYP) and\n                      <jats:sup>99m<\/jats:sup>\n                      Tc-hydroxymethylene diphosphonate (HMDP), facilitate the noninvasive diagnosis of transthyretin cardiac amyloidosis (ATTR-CA). In this study, we compared these two methods.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed 83 patients with suspected or diagnosed cardiac amyloidosis (mean age, 79\u00a0years; 11 women) who underwent PYP and HMDP scintigraphy. Early (1\u00a0h) imaging was available for of 72\/50 patients with PYP\/HMDP, and all patients underwent delayed (3\u00a0h) imaging. Visual grading (Dorbala score), heart-to-contralateral lung (H\/CL) ratios, and relative segmental uptake (RSU) derived from SPECT (3\u00a0h) polar map analysis using the quantitative perfusion SPECT software were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>visual scores showed substantial agreement. The H\/CL ratio showed a strong correlation. Bland\u2013Altman analysis revealed fixed and proportional biases, with discrepancies increasing at higher uptake levels. The median H\/CL values were comparable at 1\u00a0h, whereas HMDP showed slightly higher delayed values. Receiver operating characteristic analysis indicated excellent and good diagnostic accuracy at 1 and 3\u00a0h, respectively. Using routine diagnostic criteria, SPECT visual assessment demonstrated comparable diagnostic performance between PYP and HMDP. RSU analysis in 34 patients demonstrated similar segmental uptake distributions for both tracers, with basal and septal predominance, consistent with the apical-sparing patterns described previously.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PYP and HMDP demonstrated comparable diagnostic accuracies for ATTR-CA. PYP has been extensively validated and is suitable for early imaging, whereas HMDP has a slightly higher delayed uptake and lower blood pool activity. When interpreted using routine diagnostic criteria, SPECT provided equivalent diagnostic performance for PYP and HMDP. Segmental analyses confirmed the preservation of the characteristic apical sparing across the tracers. Both tracers are clinically interchangeable when standardized acquisition and interpretation protocols are applied.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11604-026-01978-8","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T07:25:19Z","timestamp":1773905119000},"page":"1263-1271","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Direct comparison uptake patterns of 99mTc-PYP and 99mTc-HMDP scintigraphy in cardiac amyloidosis with semi-quantitative analysis"],"prefix":"10.1007","volume":"44","author":[{"given":"Toshiya","family":"Ensako","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0989-8369","authenticated-orcid":false,"given":"Takashi","family":"Norikane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuka","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasukage","family":"Takami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuri","family":"Manabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsumasa","family":"Murao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Imajo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuya","family":"Mitamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keigo","family":"Omori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Oishi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatoshi","family":"Morimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahisa","family":"Noma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Nishiyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"1978_CR1","doi-asserted-by":"publisher","first-page":"1610","DOI":"10.1253\/circj.CJ-20-0110","volume":"84","author":"H Kitaoka","year":"2020","unstructured":"Kitaoka H, Izumi C, Izumiya Y, Inomata T, Ueda M, Kubo T, et al. JCS 2020 guideline on diagnosis and treatment of cardiac amyloidosis. Circ J. 2020;84:1610\u201371. https:\/\/doi.org\/10.1253\/circj.CJ-20-0110.","journal-title":"Circ J"},{"key":"1978_CR2","unstructured":"American Society of Nuclear Cardiology (ASNC). ASNC Practice Points on 99mTc-Pyrophosphate Imaging for Transthyretin Cardiac Amyloidosis; updated 2022. https:\/\/www.asnc.org"},{"issue":"81","key":"1978_CR3","doi-asserted-by":"publisher","first-page":"1076","DOI":"10.1016\/j.jacc.2022.11.022","volume":"2023","author":"W Committee","year":"2023","unstructured":"Committee W, Kittleson MM, Ruberg FL, Ambardekar AV, Brannagan TH, Cheng RK, et al. ACC expert consensus decision pathway on comprehensive multidisciplinary care for the patient with cardiac amyloidosis: A report of the American College of Cardiology solution set oversight committee. 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