Background:Drug-induced cardiomyopathy is a significant medical problem.Clinical diagnosis of myocardial injury is based on initial electrocardiogram,levels of circulating biomarkers,and perfusion imaging with single ...Background:Drug-induced cardiomyopathy is a significant medical problem.Clinical diagnosis of myocardial injury is based on initial electrocardiogram,levels of circulating biomarkers,and perfusion imaging with single photon emission computed tomography(SPECT).Positron emission tomography(PET)is an alternative imaging modality that provides better resolution and sensitivity than SPECT,improves diagnostic accuracy,and allows therapeutic monitoring.The objective of this study was to assess the detection of drug-induced cardiomyopathy by PET using 2-deoxy-2-[^18F]fluoro-D-glucose(FDG)and compare it with the conventional SPECT technique with[^99m Tc]-Sestamibi(MIBI).Methods:Cardiomyopathy was induced in Sprague Dawley rats using high-dose isoproterenol.Nuclear[^18F]FDG/PET and[^99m Tc]MIBI/SPECT were performed before and after isoproterenol administration.[^18F]FDG(0.1 mCi,200-400μL)and[^99m Tc]MIBI(2 mCi,200-600μL)were administered via the tail vein and imaging was performed 1 hour postinjection.Isoproterenol-induced injury was confirmed by the plasma level of cardiac troponin and triphenyltetrazolium chloride(TTC)staining.Results:Isoproterenol administration resulted in an increase in circulating cardiac troponin I and showed histologic damage in the myocardium.Visually,preisoproterenol and postisoproterenol images showed alterations in cardiac accumulation of[^18F]FDG,but not of[^99m Tc]MIBI.Image analysis revealed that myocardial uptake of[^18F]FDG reduced by 60%after isoproterenol treatment,whereas that of[^99m Tc]MIBI decreased by 45%.Conclusion:We conclude that[^18F]FDG is a more sensitive radiotracer than[^99m Tc]MIBI for imaging of drug-induced cardiomyopathy.We theorize that isoproterenolinduced cardiomyopathy impacts cellular metabolism more than perfusion,which results in more substantial changes in[^18F]FDG uptake than in[^99m Tc]MIBI accumulation in cardiac tissue.展开更多
基金National Heart,Lung,and Blood Institute,Grant/Award Number:R41HL140919-01Sandra K.and David L.Gilliland Chair in Nuclear Pharmacy。
文摘Background:Drug-induced cardiomyopathy is a significant medical problem.Clinical diagnosis of myocardial injury is based on initial electrocardiogram,levels of circulating biomarkers,and perfusion imaging with single photon emission computed tomography(SPECT).Positron emission tomography(PET)is an alternative imaging modality that provides better resolution and sensitivity than SPECT,improves diagnostic accuracy,and allows therapeutic monitoring.The objective of this study was to assess the detection of drug-induced cardiomyopathy by PET using 2-deoxy-2-[^18F]fluoro-D-glucose(FDG)and compare it with the conventional SPECT technique with[^99m Tc]-Sestamibi(MIBI).Methods:Cardiomyopathy was induced in Sprague Dawley rats using high-dose isoproterenol.Nuclear[^18F]FDG/PET and[^99m Tc]MIBI/SPECT were performed before and after isoproterenol administration.[^18F]FDG(0.1 mCi,200-400μL)and[^99m Tc]MIBI(2 mCi,200-600μL)were administered via the tail vein and imaging was performed 1 hour postinjection.Isoproterenol-induced injury was confirmed by the plasma level of cardiac troponin and triphenyltetrazolium chloride(TTC)staining.Results:Isoproterenol administration resulted in an increase in circulating cardiac troponin I and showed histologic damage in the myocardium.Visually,preisoproterenol and postisoproterenol images showed alterations in cardiac accumulation of[^18F]FDG,but not of[^99m Tc]MIBI.Image analysis revealed that myocardial uptake of[^18F]FDG reduced by 60%after isoproterenol treatment,whereas that of[^99m Tc]MIBI decreased by 45%.Conclusion:We conclude that[^18F]FDG is a more sensitive radiotracer than[^99m Tc]MIBI for imaging of drug-induced cardiomyopathy.We theorize that isoproterenolinduced cardiomyopathy impacts cellular metabolism more than perfusion,which results in more substantial changes in[^18F]FDG uptake than in[^99m Tc]MIBI accumulation in cardiac tissue.
文摘目的探讨^(99m)Tc-3PRGD2 SPECT/CT显像半定量参数对可疑乳腺病变的诊断价值,并根据乳腺癌分子分型进行分类比较,分析其与临床病理的相关性。方法收集2020年12月~2022年8月于我院接受检查的70例可疑乳腺病变患者病例资料。根据病理结果,分析乳腺癌Luminal阳性型、Her-2阳性型和三阴性型3种分子亚型与T/N值的相关性;分析雌激素受体、孕激素受体、Her-2及Ki67表达情况与影像学检查指标的关系。结果70例患者病理检查结果证实乳腺癌51例(72.86%),病理分型为Luminal阳性型22例,Her-2阳性型20例,三阴性型9例。乳腺良性病变24例(27.14%)。乳腺癌患者病变侧T/N值高于良性病变患者(3.96±0.82 vs 1.16±0.32),差异有统计学意义(t=14.426,P<0.05)。诊断特异性为84.21%(16/19),敏感度为82.35%(42/51),准确率为82.86%(58/70),ROC曲线下面积为0.834(0.755~0.913),诊断临界值为1.56,即T/N值≥1.56时判定为恶性病变。Her-2阳性型的T/N值高于三阴性型(P<0.05)。Her-2表达阳性患者的T/N值高于Her-2表达阴性的患者(P<0.05)。雌激素受体、孕激素受体和Ki67表达阳性和表达阴性患者的T/N值相比,差异均无统计学意义(P>0.05)。结论^(99m)Tc-3PRGD2 SPECT/CT显像半定量指标在诊断乳腺病变良恶性方面有较高的敏感度,并且Her-2阳性型患者T/N值明显升高,有助于早期发现和诊断乳腺病变,为预测乳腺癌分子分型和治疗有相应的指导作用。
