{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T08:39:30Z","timestamp":1753519170686},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T00:00:00Z","timestamp":1665705600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T00:00:00Z","timestamp":1665705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Ministry of Health and Welfare, Republic of Korea","award":["HI14C1277"],"award-info":[{"award-number":["HI14C1277"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We aimed to evaluate the reliability and feasibility of visual grading systems and various quantitative indexes of [<jats:sup>99m<\/jats:sup>Tc]Tc-DPD imaging for cardiac amyloidosis (CA). Patients who underwent [<jats:sup>99m<\/jats:sup>Tc]Tc-DPD imaging with suspicion of CA were enrolled. On the planar image, myocardial uptake was visually graded using Perugini\u2019s and Dorbala\u2019s methods (PS and DS). As [<jats:sup>99m<\/jats:sup>Tc]Tc-DPD indexes, heart-to-whole body ratio (H\/WB) and heart-to-contralateral lung ratio (H\/CL) were measured on planar image. SUVmax, SUVmean, total myocardial uptake (TMU), and C-index were measured on SPECT\/CT. Inter-observer agreement of the indexes and their association with visual grading and clinical factors were evaluated. A total of 152 [<jats:sup>99m<\/jats:sup>Tc]Tc-DPD images, of which 18 were positive, were analyzed. Inter-observer agreement was high for both DS (\u03ba\u2009=\u20090.95) and PS (\u03ba\u2009=\u20090.96). However, DS showed a higher correlation with quantitative indexes than PS. Inter-observer agreement was also high for SPECT\/CT indexes, particularly SUVmax. SUVmax was significantly different between different DS groups (<jats:italic>P<\/jats:italic>\u2009=\u20090.014\u20130.036), and showed excellent correlations with H\/WB and H\/CL (<jats:italic>r<\/jats:italic>\u2009=\u20090.898 and 0.910). SUVmax also showed significant differences between normal, AL, and ATTR pathology (<jats:italic>P<\/jats:italic>\u2009=\u20090.022\u20130.037), and a significant correlation with extracellular volume on cardiac MRI (<jats:italic>r<\/jats:italic>\u2009=\u20090.772, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). DS is a visual grading system for CA that is more significantly matched with quantitative indexes than PS. SUVmax is a reliable quantitative index on SPECT\/CT, with a high inter-observer agreement, correlations with the visual grade, and potential association with cardiac MRI findings.<\/jats:p>","DOI":"10.1038\/s41598-022-21603-8","type":"journal-article","created":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T15:03:07Z","timestamp":1665759787000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Reliability and feasibility of visual grading systems and quantitative indexes on [99mTc]Tc-DPD imaging for cardiac amyloidosis"],"prefix":"10.1038","volume":"12","author":[{"given":"Sungwoo","family":"Bae","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joonhyung","family":"Gil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin Chul","family":"Paeng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eun-Ah","family":"Park","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung-Pyo","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongyoon","family":"Choi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keon Wook","family":"Kang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gi Jeong","family":"Cheon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong Soo","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,10,14]]},"reference":[{"key":"21603_CR1","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1038\/s41569-020-0334-7","volume":"17","author":"A Martinez-Naharro","year":"2020","unstructured":"Martinez-Naharro, A., Baksi, A. J., Hawkins, P. N. & Fontana, M. Diagnostic imaging of cardiac amyloidosis. Nat. Rev. Cardiol. 17, 413\u2013426. https:\/\/doi.org\/10.1038\/s41569-020-0334-7 (2020).","journal-title":"Nat. Rev. Cardiol."},{"key":"21603_CR2","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1007\/s13139-020-00681-4","volume":"55","author":"JC Paeng","year":"2021","unstructured":"Paeng, J. C. & Choi, J. Y. Nuclear imaging for cardiac amyloidosis: Bone scan, SPECT\/CT and amyloid-targeting PET. Nucl. Med. Mol. Imaging 55, 61\u201370. https:\/\/doi.org\/10.1007\/s13139-020-00681-4 (2021).","journal-title":"Nucl. Med. Mol. Imaging"},{"key":"21603_CR3","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.1056\/NEJMoa1805689","volume":"379","author":"MS Maurer","year":"2018","unstructured":"Maurer, M. S. et al. Tafamidis treatment for patients with transthyretin amyloid cardiomyopathy. N. Engl. J. Med. 379, 1007\u20131016. https:\/\/doi.org\/10.1056\/NEJMoa1805689 (2018).","journal-title":"N. Engl. J. Med."},{"key":"21603_CR4","doi-asserted-by":"publisher","first-page":"2404","DOI":"10.1161\/CIRCULATIONAHA.116.021612","volume":"133","author":"JD Gillmore","year":"2016","unstructured":"Gillmore, J. D. et al. Nonbiopsy diagnosis of cardiac transthyretin amyloidosis. Circulation 133, 2404\u20132412. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.116.021612 (2016).","journal-title":"Circulation"},{"key":"21603_CR5","doi-asserted-by":"publisher","first-page":"965","DOI":"10.2967\/jnumed.120.245381","volume":"61","author":"A Masri","year":"2020","unstructured":"Masri, A., Bukhari, S., Eisele, Y. S. & Soman, P. Molecular imaging of cardiac amyloidosis. J. Nucl. Med. 61, 965\u2013970. https:\/\/doi.org\/10.2967\/jnumed.120.245381 (2020).","journal-title":"J. Nucl. Med."},{"key":"21603_CR6","doi-asserted-by":"publisher","first-page":"1456","DOI":"10.1007\/s12350-019-01893-8","volume":"27","author":"F Caobelli","year":"2020","unstructured":"Caobelli, F., Braun, M., Haaf, P., Wild, D. & Zellweger, M. J. Quantitative (99m)Tc-DPD SPECT\/CT in patients with suspected ATTR cardiac amyloidosis: Feasibility and correlation with visual scores. J. Nucl. Cardiol. 27, 1456\u20131463. https:\/\/doi.org\/10.1007\/s12350-019-01893-8 (2020).","journal-title":"J. Nucl. Cardiol."},{"key":"21603_CR7","doi-asserted-by":"publisher","first-page":"1353","DOI":"10.1016\/j.jcmg.2020.03.020","volume":"13","author":"PR Scully","year":"2020","unstructured":"Scully, P. R. et al. DPD quantification in cardiac amyloidosis: A novel imaging biomarker. JACC Cardiovasc. Imaging 13, 1353\u20131363. https:\/\/doi.org\/10.1016\/j.jcmg.2020.03.020 (2020).","journal-title":"JACC Cardiovasc. Imaging"},{"key":"21603_CR8","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1080\/13506129.2018.1520087","volume":"25","author":"JC Ross","year":"2018","unstructured":"Ross, J. C. et al. Quantitation of (99m)Tc-DPD uptake in patients with transthyretin-related cardiac amyloidosis. Amyloid 25, 203\u2013210. https:\/\/doi.org\/10.1080\/13506129.2018.1520087 (2018).","journal-title":"Amyloid"},{"key":"21603_CR9","doi-asserted-by":"publisher","first-page":"1822","DOI":"10.1007\/s00259-020-05144-8","volume":"48","author":"V Lofbacka","year":"2021","unstructured":"Lofbacka, V. et al. Cardiac transthyretin amyloidosis (99m)Tc-DPD SPECT correlates with strain echocardiography and biomarkers. Eur. J. Nucl. Med. Mol. Imaging 48, 1822\u20131832. https:\/\/doi.org\/10.1007\/s00259-020-05144-8 (2021).","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"21603_CR10","doi-asserted-by":"publisher","first-page":"716","DOI":"10.2967\/jnumed.120.247312","volume":"62","author":"S Dorbala","year":"2021","unstructured":"Dorbala, S. et al. Absolute quantitation of cardiac (99m)Tc-pyrophosphate using Cadmium-Zinc-Telluride-Based SPECT\/CT. J. Nucl. Med. 62, 716\u2013722. https:\/\/doi.org\/10.2967\/jnumed.120.247312 (2021).","journal-title":"J. Nucl. Med."},{"key":"21603_CR11","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1186\/s40658-020-00342-7","volume":"8","author":"C Ren","year":"2021","unstructured":"Ren, C. et al. Assessment of cardiac amyloidosis with (99m)Tc-pyrophosphate (PYP) quantitative SPECT. EJNMMI Phys. 8, 3. https:\/\/doi.org\/10.1186\/s40658-020-00342-7 (2021).","journal-title":"EJNMMI Phys."},{"key":"21603_CR12","doi-asserted-by":"publisher","first-page":"e006075","DOI":"10.1161\/CIRCHEARTFAILURE.119.006075","volume":"12","author":"MS Maurer","year":"2019","unstructured":"Maurer, M. S. et al. Expert consensus recommendations for the suspicion and diagnosis of transthyretin cardiac amyloidosis. Circ. Heart Fail. 12, e006075. https:\/\/doi.org\/10.1161\/CIRCHEARTFAILURE.119.006075 (2019).","journal-title":"Circ. Heart Fail."},{"key":"21603_CR13","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1007\/s12350-013-9803-2","volume":"21","author":"S Bokhari","year":"2014","unstructured":"Bokhari, S., Shahzad, R., Castano, A. & Maurer, M. S. Nuclear imaging modalities for cardiac amyloidosis. J. Nucl. Cardiol. 21, 175\u2013184. https:\/\/doi.org\/10.1007\/s12350-013-9803-2 (2014).","journal-title":"J. Nucl. Cardiol."},{"key":"21603_CR14","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1186\/s13550-021-00828-0","volume":"11","author":"S Ben-Haim","year":"2021","unstructured":"Ben-Haim, S. et al. Quantitative SPECT\/CT parameters of myocardial (99m)Technetium-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD) uptake in suspected cardiac transthyretin amyloidosis. EJNMMI Res. 11, 86. https:\/\/doi.org\/10.1186\/s13550-021-00828-0 (2021).","journal-title":"EJNMMI Res."},{"key":"21603_CR15","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1161\/CIRCRESAHA.117.310982","volume":"121","author":"E Muchtar","year":"2017","unstructured":"Muchtar, E., Blauwet, L. A. & Gertz, M. A. Restrictive cardiomyopathy: Genetics, pathogenesis, clinical manifestations, diagnosis and therapy. Circ. Res. 121, 819\u2013837. https:\/\/doi.org\/10.1161\/CIRCRESAHA.117.310982 (2017).","journal-title":"Circ. Res."},{"key":"21603_CR16","doi-asserted-by":"publisher","first-page":"204589401982604","DOI":"10.1177\/2045894019826043","volume":"9","author":"V Agrawal","year":"2019","unstructured":"Agrawal, V., Byrd, B. F. 3rd. & Brittain, E. L. Echocardiographic evaluation of diastolic function in the setting of pulmonary hypertension. Pulm. Circ. 9, 2045894019826043. https:\/\/doi.org\/10.1177\/2045894019826043 (2019).","journal-title":"Pulm. Circ."},{"key":"21603_CR17","first-page":"1","volume":"12","author":"MA Bujang","year":"2017","unstructured":"Bujang, M. A. & Baharum, N. A simplified guide to determination of sample size requirements for estimating the value of intraclass correlation coefficient: A review. Arch. Orofac. Sci. 12, 1\u201311 (2017).","journal-title":"Arch. Orofac. Sci."},{"key":"21603_CR18","doi-asserted-by":"publisher","first-page":"2483","DOI":"10.1007\/s12350-021-02715-6","volume":"28","author":"I Schatka","year":"2021","unstructured":"Schatka, I. et al. An optimized imaging protocol for [(99m)Tc]Tc-DPD scintigraphy and SPECT\/CT quantification in cardiac transthyretin (ATTR) amyloidosis. J. Nucl. Cardiol. 28, 2483\u20132496. https:\/\/doi.org\/10.1007\/s12350-021-02715-6 (2021).","journal-title":"J. Nucl. Cardiol."},{"key":"21603_CR19","doi-asserted-by":"publisher","first-page":"1076","DOI":"10.1016\/j.jacc.2005.05.073","volume":"46","author":"E Perugini","year":"2005","unstructured":"Perugini, E. et al. Noninvasive etiologic diagnosis of cardiac amyloidosis using 99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid scintigraphy. J. Am. Coll. Cardiol. 46, 1076\u20131084. https:\/\/doi.org\/10.1016\/j.jacc.2005.05.073 (2005).","journal-title":"J. Am. Coll. Cardiol."},{"key":"21603_CR20","doi-asserted-by":"publisher","first-page":"2065","DOI":"10.1007\/s12350-019-01760-6","volume":"26","author":"S Dorbala","year":"2019","unstructured":"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. J. Nucl. Cardiol. 26, 2065\u20132123. https:\/\/doi.org\/10.1007\/s12350-019-01760-6 (2019).","journal-title":"J. Nucl. Cardiol."},{"key":"21603_CR21","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1016\/j.jacc.2016.12.037","volume":"69","author":"SS Mitter","year":"2017","unstructured":"Mitter, S. S., Shah, S. J. & Thomas, J. D. A test in context: E\/A and E\/e\u2019 to assess diastolic dysfunction and LV filling pressure. J. Am. Coll. Cardiol. 69, 1451\u20131464. https:\/\/doi.org\/10.1016\/j.jacc.2016.12.037 (2017).","journal-title":"J. Am. Coll. Cardiol."},{"key":"21603_CR22","doi-asserted-by":"publisher","first-page":"e005588","DOI":"10.1161\/CIRCIMAGING.116.005588","volume":"10","author":"ED Pagourelias","year":"2017","unstructured":"Pagourelias, E. D. et al. Echo parameters for differential diagnosis in cardiac amyloidosis: A head-to-head comparison of deformation and nondeformation parameters. Circ. Cardiovasc. Imaging 10, e005588. https:\/\/doi.org\/10.1161\/CIRCIMAGING.116.005588 (2017).","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"21603_CR23","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1186\/s12968-016-0308-4","volume":"18","author":"P Haaf","year":"2016","unstructured":"Haaf, P. et al. Cardiac T1 mapping and extracellular volume (ECV) in clinical practice: A comprehensive review. J. Cardiovasc. Magn. Reson. 18, 89. https:\/\/doi.org\/10.1186\/s12968-016-0308-4 (2016).","journal-title":"J. Cardiovasc. Magn. Reson."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-21603-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-21603-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-21603-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T15:14:49Z","timestamp":1665760489000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-21603-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,14]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["21603"],"URL":"https:\/\/doi.org\/10.1038\/s41598-022-21603-8","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,14]]},"assertion":[{"value":"8 February 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 September 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 October 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"17271"}}