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. 2024 Jan 16;2(1):qyad025.
doi: 10.1093/ehjimp/qyad025. eCollection 2024 Jan.

Appraisal of amyloidosis imaging practices in the Middle East/North Africa (PYP-MENA)

Firas Al Badarin  1   2 , Masoud Garashi  3 , Ahmed Aljizeeri  4 , Ramzi Tabbalat  5 , Adel Allam  6 , Salah Eddine Bouyoucef  7 , Ammar Chauhdary  8
Affiliations

Appraisal of amyloidosis imaging practices in the Middle East/North Africa (PYP-MENA)

Firas Al Badarin et al. Eur Heart J Imaging Methods Pract. .

Abstract

Aims: Whereas recommendations to optimize performance and yield of cardiac scintigraphy studies with bone-seeking tracers have been published, little is known about real-world adherence to these best practices, especially outside North America and Europe. Accordingly, we described imaging practices with this modality in a sample of nuclear laboratories in the Middle East/North Africa (MENA) region.

Methods and results: Laboratories performing radionuclide imaging for cardiac amyloidosis in the MENA region were invited to participate in this study to describe installed camera systems, type and dose of bone-avid tracers used, imaging protocols, and criteria used for study interpretation. Out of 19 invited sites, 10 completed the survey (70% government-run; 90% accredited), sites have been involved with amyloid imaging for a median of 49 months (interquartile range 24-60). The median injected dose was 20 mCi (range 10-25), and PYP was used by 90% of sites in this sample. Planar imaging with single photon emission computed tomography (SPECT) reconstruction was performed at all sites, including seven sites that performed SPECT/CT reconstruction. Lastly, only 50% of sites relied on evidence of myocardial uptake by SPECT to confirm the diagnosis of ATTR cardiomyopathy, while the rest relied on visual assessment and heart/contralateral ratio.

Conclusion: This study is the first to describe variation in imaging practices across sites in the MENA region, especially in acquisition protocols and interpretation standards. Eliminating heterogeneities identified by this study will harmonize image interpretation and reporting and will facilitate successful conduct of regional multi-centre studies.

Keywords: SPECT; amyloidosis; bone-avid tracers.

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Conflict of interest statement

Conflict of interest: F.A.B. received research support from Pfizer Gulf FZ LLC. Other authors have nothing to disclose.

Figures

Graphical abstract
Graphical abstract
Adherence to imaging best practices at sites participating in PYP-MENA study.
Figure 1
Figure 1
Distribution of site responses to questions on tracers, camera systems, imaging protocols, and interpretation criteria.
See this image and copyright information in PMC

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