What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Wild-type transthyretin amyloidosis cardiomyopathy (ATTRwt-CM) (n=29). Intervention: [123I]-MIBG SPECT/CT. Primary outcome: Feasibility of absolute quantification of [123I]-MIBG SPECT/CT and correlation with semi-quantitative measures.

What does this research mean for the field?

Volumetric quantification of [123I]-MIBG SPECT/CT is feasible in patients with wild-type transthyretin amyloidosis cardiomyopathy, yielding SUV metrics that correlate with semi-quantitative measures but not with echocardiography or CMR parameters. Novelty: ClaimNovelty.METHODOLOGICAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

February 3, 2025Open Access

Feasibility of the absolute quantification and left ventricular segmentation of cardiac sympathetic innervation in wild-type transthyretin amyloidosis cardiomyopathy with 123I-MIBG SPECT/CT: The I-NERVE study

ATAlwin TubbenUniversity Medical Center Groningen NPNiek H. J. PrakkenUniversity Medical Center Groningen OIOleksandra IvashchenkoUniversity Medical Center Groningen

Key Result

Volumetric quantification of [123I]-MIBG SPECT/CT was feasible in ATTRwt-CM patients, yielding SUV metrics that correlated with semi-quantitative measures but not with echocardiography or CMR.

Study Design

Type

Cross-Sectional (n=29)

Multicenter

Structured PICO

Does [123I]-MIBG SPECT/CT correlate with functional and structural cardiac parameters in wild-type transthyretin amyloidosis cardiomyopathy?

Population

Patients with wild-type transthyretin amyloidosis cardiomyopathy

Intervention

[123I]-MIBG SPECT/CT

Outcome

Correlation of [123I]-MIBG SPECT/CT values with global longitudinal systolic strain (GLSS) on echocardiography, native-T1, and extracellular volume (ECV) on CMRsurrogate

[123I]-MIBG SPECT/CT measures of cardiac sympathetic innervation do not correlate with GLSS, native T1, or ECV in wild-type transthyretin amyloidosis cardiomyopathy.

Limitations

Single-center study with a small sample size
No control group
Residual confounding cannot be ruled out
Homogeneous cohort may have restricted the detection of correlations
Retrospective quantification using a fixed conversion factor may have introduced scanner sensitivity variations
SPECT/CT segmentation was performed manually
No established cut-off value in ATTRwt-CM for stratification of cardiovascular outcomes

Abstract

BACKGROUND: I]-MIBG single-photon emission computed tomography/ computed tomography (SPECT/CT) and correlate findings with functional and structural cardiac parameters from echocardiogram and cardiac magnetic resonance imaging (CMR). METHODS: I]-MIBG SPECT/CT values were correlated with global longitudinal systolic strain (GLSS) on echocardiography, native-T1, and extracellular volume (ECV) on CMR using SPECT/CT fused with CMR. RESULTS: I]-MIBG measures. No correlations were found with GLSS on echocardiography or native T1 and ECV on CMR. CONCLUSIONS: I]-MIBG SPECT/CT to different aspects of cardiac function or pathology. TRIAL REGISTRATION: EudraCT ref. 2020-003350-72, retrospectively registered March 20, 2023. https://classic. CLINICALTRIALS: gov/ct2/show/NCT05776212.

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